Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 332BC3200X | Durable Medical Equipment & Medical Supplies | Customized Equipment | HME 1608 | FLORIDA | No |
| 2 | 332BN1400X | Durable Medical Equipment & Medical Supplies | Nursing Facility Supplies | HME 1608 | FLORIDA | No |
| 3 | 332BP3500X | Durable Medical Equipment & Medical Supplies | Parenteral & Enteral Nutrition | HME 1608 | FLORIDA | No |
| 4 | 332BX2000X | Durable Medical Equipment & Medical Supplies | Oxygen Equipment & Supplies | HME 1608 | FLORIDA | No |
| 5 | 335E00000X | Prosthetic/Orthotic Supplier | | HME 1608 | FLORIDA | No |
| 6 | 332B00000X | Durable Medical Equipment & Medical Supplies | | HME 1608 | FLORIDA | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 025612900 | MEDICAID | FLORIDA | |
| 2 | 1419733 | OTHER | FLORIDA | BCBS OF PA PROVIDER |
| 3 | 629332 | OTHER | FLORIDA | ANTHEM BCBS PROVIDER |
| 4 | 686600096 | MEDICAID | FLORIDA | |
| 5 | 684602500 | MEDICAID | FLORIDA | |
| 6 | 722Y3MD | OTHER | FLORIDA | BCBS OF MN PROVIDER |
| 7 | R9698 | OTHER | FLORIDA | BCBC PROVIDER NUMBER |
| 8 | 218895 | MEDICAID | FLORIDA | |
| 9 | 35633687 | OTHER | FLORIDA | AETNA PROVIDER NUMBER |
| 10 | 114400XX | OTHER | FLORIDA | PREFERRED CARE PROVIDER |
