Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | ME0056597 | FL |
NPI | 1275529067 |
---|---|
Provider Name | Tony Bien-Aime |
First Address | Miami, FL 33055-4709 |
Second Address | Miami, FL 33055-4709 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2005 |
Last Update Date | 29/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
063568500 | (05) | FL |
E61648 | (02) | FL |