Organization Name: | VENETIAN ISLE MEDICAL OB GYN CONSULTANT INC |
NPI Number: | 1669500328 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WAYNE P. DIGIACOMO (PRESIDENT) |
Mailing Address: | 3001 W Hallandale Beach Blvd Suite 200 Hallandale |
State: | FL US |
Postal Code: | 330095155 |
Phone Number: | 9544564888 |
Fax Number: | 9544569721 |
NPI Enumeration Date: | 03/02/2007 |
NPI Last Update Date: | 06/02/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | ME34571 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |