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 | 207RC0000X | Internal Medicine | Cardiovascular Disease | ME35621 | 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 | 061697 | OTHER | | STAYWELL HMO |
| 2 | 1013516 | OTHER | | CARE PLUS HEALTH PLANS |
| 3 | 53807 | OTHER | | HEALTH SUN |
| 4 | 95577 | MEDICARE PIN | FLORIDA | |
| 5 | 1619975893 | OTHER | | VISTA-HIP |
| 6 | 95577 | OTHER | | BCBS |
| 7 | D63520 | OTHER | | SUMMIT HEALTH PLAN |
| 8 | 0745NSHR | OTHER | | NEIGHBORHOOD PPO/HMO |
| 9 | 0852925 | OTHER | | AETNA |
| 10 | 2570046 | OTHER | | UNITED HEALTH CARE OF FL HMO |
| 11 | 5127 | OTHER | | CARE ACCESS |
| 12 | 650088572F | OTHER | | HYMANA HMO |
| 13 | P00230 | OTHER | | DOCTORS CARE |
| 14 | 0713965 | OTHER | | CIGNA PPO |
| 15 | 2320066 | OTHER | | AETNA MANAGED CHOICE/OPEN |
| 16 | 008230 | OTHER | | AVMED |
| 17 | 068387600 | OTHER | | MEDIPASS |
| 18 | 01697 | OTHER | | HEALTHEASE FO FLORIDA HMO |
| 19 | 0713965 | OTHER | | CIGNA HMO |
| 20 | 171362 | OTHER | | JMH |
| 21 | 0619975893 | OTHER | | RAIL ROAD MEDICARE |
| 22 | 116436 | OTHER | | AMERIGROUP |
| 23 | D63520 | MEDICARE UPIN | FLORIDA | |
| 24 | 061697 | OTHER | | WELL CARE |
| 25 | 0852925 | OTHER | | AETNA OPEN ACCESS-HMO |
| 26 | 2570046 | OTHER | | UNITED HEALTH CARE OF FLORIDA PPO |
| 27 | 068387600 | MEDICAID | FLORIDA | |
| 28 | 95577 | OTHER | | BLUE CROSS BLUE SHIELD |
| 29 | 650088572F | OTHER | | HUMANA PPO |
