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 | 207VX0201X | Obstetrics & Gynecology | Gynecologic Oncology | ME0069610 | 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 | 7799947 | OTHER | FLORIDA | GHI PPO PROVIDER NUMBER |
| 2 | 196902 | OTHER | FLORIDA | WELLCARE PROVIDER NUMBER |
| 3 | 221296 | OTHER | FLORIDA | AVMED THRU PARITY PROV. # |
| 4 | 44206Y | MEDICARE PIN | FLORIDA | |
| 5 | 347762 | OTHER | FLORIDA | USA MNGD CR. PROVIDER # |
| 6 | 38317 | OTHER | FLORIDA | NEIGHBORHOOD PROV. # |
| 7 | 4348033 | OTHER | FLORIDA | AETNA PROVIDER NUMBER |
| 8 | 44206 | OTHER | FLORIDA | BCBS OF FL. PROVIDER # |
| 9 | 3405 | OTHER | FLORIDA | TOTAL HLTH. CH. PROV. # |
| 10 | 255041500 | MEDICAID | FLORIDA | |
| 11 | 000021064-W | OTHER | FLORIDA | HUMANA PROVIDER NUMBER |
| 12 | 1083764 | OTHER | FLORIDA | FIRST HEALTH PROVIDER # |
| 13 | 0520889-002 | OTHER | FLORIDA | CIGNA PPO & HMO PROV. # |
| 14 | G54533 | OTHER | FLORIDA | VISTA PROVIDER NUMBER |
| 15 | G54533 | MEDICARE UPIN | | |
