Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | D23308 | MD |
NPI | 1003875295 |
---|---|
Provider Name | Victor M Priego |
First Address | Fort Myers, FL 33905-7808 |
Second Address | Bethesda, MD 20817-1809 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2006 |
Last Update Date | 29/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C62454 | (02) |