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 | 2471R0002X | Radiologic Technologist | Radiation Therapy | 3516-3 | 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 | 039549800 | MEDICAID | FLORIDA | |
| 2 | D55009 | MEDICARE UPIN | FLORIDA | |
| 3 | B27236 | MEDICARE UPIN | FLORIDA | |
| 4 | D55480 | MEDICARE UPIN | FLORIDA | |
| 5 | 99507 | MEDICARE PIN | FLORIDA | |
| 6 | B71902 | MEDICARE UPIN | FLORIDA | |
| 7 | 08208 | MEDICARE ID-TYPE UNSPECIFIED | FLORIDA | EGERGTON VAN DEN BERG,M.D |
| 8 | 048179300 | MEDICAID | FLORIDA | |
| 9 | 035671900 | MEDICAID | FLORIDA | |
| 10 | 48856 | MEDICARE ID-TYPE UNSPECIFIED | FLORIDA | JAMES BOLEN,M.D. |
| 11 | 060056403 | MEDICARE ID-TYPE UNSPECIFIED | FLORIDA | ROBERT ROTHBARD RAILROAD |
| 12 | 060053197 | MEDICARE ID-TYPE UNSPECIFIED | FLORIDA | JAMES BOLEN RAILROAD MEDI |
| 13 | 060053196 | MEDICARE ID-TYPE UNSPECIFIED | FLORIDA | ROBERT BOSWELL RAILROAD M |
| 14 | 99507 | OTHER | FLORIDA | BLUE CROSS GROUP |
| 15 | 47318 | MEDICARE ID-TYPE UNSPECIFIED | FLORIDA | ROBERT BOSWELL,M.D. |
| 16 | 05909 | MEDICARE ID-TYPE UNSPECIFIED | FLORIDA | ROBERT ROTHBARD,M.D. |
| 17 | 061472600 | MEDICAID | FLORIDA | |
| 18 | 060056404 | MEDICARE ID-TYPE UNSPECIFIED | FLORIDA | VAN DEN BERG RAILROAD |
