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 | 207RP1001X | Internal Medicine | Pulmonary Disease | OS3300 | 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 | 81895 | OTHER | FLORIDA | OUT OF STATE BLUE CROSS BLUE SHIELD |
| 2 | 0678454 | OTHER | FLORIDA | CIGNA PPO/HMO, OPEN ACCESS |
| 3 | 591273247 | OTHER | | UHC NY STATE EMPIRE PLAN |
| 4 | 81895 | OTHER | FLORIDA | BLUE OPTIONS, BLUE CHOICE, FEDERAL, FLORIDA STATE AND TRADITIONAL BCBS |
| 5 | 388453 | OTHER | FLORIDA | UNITED HEALTHCARE COMMERCIAL AND MEDICARE PLANS |
| 6 | 81895 | OTHER | FLORIDA | BCBS BLUE CARE, ADVANTAGE 65 SELECT, MEDICARE PPO/HMO, GO BLUE |
| 7 | 738136 | OTHER | | MAIL HANDLERS BENEFIT PLAN (MHBP) |
| 8 | E32090 | MEDICARE UPIN | | |
| 9 | 81895Z | MEDICARE ID-TYPE UNSPECIFIED | | |
| 10 | 10316 | OTHER | FLORIDA | FLORIDA WELLCARE (MEDICARE PLAN) |
| 11 | 059637000 | MEDICAID | FLORIDA | |
