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 | 332B00000X | Durable Medical Equipment & Medical Supplies | | 1312499 | 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 | NA | OTHER | FLORIDA | CIGNA |
| 2 | NA | OTHER | FLORIDA | UMR |
| 3 | 1073574331 | OTHER | FLORIDA | UNITED HEALTHCARE BENESIGHT HARRINGTION |
| 4 | 1073574331 | OTHER | FLORIDA | PED-I-CARE |
| 5 | 1073574331 | OTHER | FLORIDA | EVOLUTIONS HEALTHCARE SYSTEM |
| 6 | 11141501 | OTHER | FLORIDA | CITRUS HEALTHCARE |
| 7 | NA | OTHER | FLORIDA | COVENTRY NATIONAL NETWORK |
| 8 | 1073574331 | OTHER | | THREE RIVERS NETWORK |
| 9 | 1073574331 | OTHER | FLORIDA | UNITED HEALTHCARE GOLDEN RULE |
| 10 | NA | OTHER | FLORIDA | SUNSHINE STATE HEALTH PLAN |
| 11 | NA | OTHER | FLORIDA | STAYWELL IN SELECT COUNTIES |
| 12 | NA | OTHER | FLORIDA | HUMANA |
| 13 | R9670 | OTHER | FLORIDA | BLUE CROSS BLUE SHIELD FL |
| 14 | NA | OTHER | FLORIDA | AETNA |
| 15 | NA | OTHER | FLORIDA | FIRST COAST ADVANTAGE |
| 16 | NA | OTHER | FLORIDA | INTEGRAL QUALITY CARE |
| 17 | 1028538 | OTHER | FLORIDA | UNITED HEALTHCARE |
| 18 | 1073574331 | MEDICAID | FLORIDA | |
| 19 | NA | OTHER | FLORIDA | HEALTHEASE IN SELECT COUNTIES |
| 20 | NA | OTHER | FLORIDA | ASSURANT HEALTH PLAN |
