Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 116360 | FL |
NPI | 1023321486 |
---|---|
Provider Name | Tommy C Yu |
First Address | Ponte Vedra, FL 32082-2740 |
Second Address | Jacksonville, FL 32216-4252 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2010 |
Last Update Date | 01/08/2013 |