Doctor Name: | ERIC C UMBREIT |
NPI Number: | 1538363577 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | |
Business Practice Address: | 341 Racetrack Rd Nw Suite B Fort Walton Beach, FL - 325471552 |
Business Phone Number: | 8508630883 |
Business Fax Number: | 8503154284 |
Mailing Address: | 341 Racetrack Rd Nw, Suite B FORT WALTON BEACH |
State: | FL |
Postal Code: | 325471552 |
Phone Number: | 8508630883 |
Fax Number: | 8503154284 |
NPI Enumeration Date: | 06/13/2007 |
NPI Last Update Date: | 11/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |