Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | DN 8749 | FL |
Y | 213EG0000X | General Practice | DN 8749 | FL |
NPI | 1003914276 |
---|---|
Provider Name | Steven Scott Riley |
First Address | Gainesville, FL 32653-3248 |
Second Address | Gainesville, FL 32608-1135 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |