Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | ME49835 | FL |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | ME49835 | FL |
NPI | 1053409144 |
---|---|
Provider Name | Segismundo Pares |
First Address | Ocala, FL 34474-4454 |
Second Address | Ocala, FL 34474-4454 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 04/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
061627300 | (05) | FL |
D61082 | (02) | FL |