Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | OS 9880 | FL |
NPI | 1144332735 |
---|---|
Provider Name | Steven Constantine |
First Address | Park City, UT 84098-5189 |
Second Address | Lake Mary, FL 32746 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 08/07/2007 |