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 | 2080P0207X | Pediatrics | Pediatric Hematology-Oncology | | | No |
| 2 | 2080P0204X | Pediatrics | Pediatric Emergency Medicine | | | No |
| 3 | 2080P0006X | Pediatrics | Developmental - Behavioral Pediatrics | | | No |
| 4 | 207SG0201X | Medical Genetics | Clinical Genetics (M.D.) | | | No |
| 5 | 208200000X | Plastic Surgery | | | | No |
| 6 | 207ZP0102X | Pathology | Anatomic Pathology & Clinical Pathology | | | No |
| 7 | 2086S0120X | Surgery | Pediatric Surgery | | | No |
| 8 | 2080P0202X | Pediatrics | Pediatric Cardiology | | | No |
| 9 | 2084P0804X | Psychiatry & Neurology | Child & Adolescent Psychiatry | | | No |
| 10 | 261QD0000X | Clinic/Center | Dental | | | No |
| 11 | 2080P0208X | Pediatrics | Pediatric Infectious Diseases | | | No |
| 12 | 103TC2200X | Psychologist | Clinical Child & Adolescent | | | No |
| 13 | 208000000X | Pediatrics | | | | 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 | 21399 | OTHER | FLORIDA | BLUE CROSS BLUE SHIELD |
| 2 | 252285316 | MEDICAID | FLORIDA | |
| 3 | 00222 | OTHER | FLORIDA | BLUE SHIELD OF FLORIDA |
| 4 | 252285300 | MEDICAID | FLORIDA | |
| 5 | 252285306 | MEDICAID | FLORIDA | |
| 6 | 252285317 | MEDICAID | FLORIDA | |
| 7 | 252285318 | MEDICAID | FLORIDA | |
| 8 | 252285319 | MEDICAID | FLORIDA | |
| 9 | 252285301 | MEDICAID | FLORIDA | |
| 10 | 252285321 | MEDICAID | FLORIDA | |
| 11 | 252285307 | MEDICAID | FLORIDA | |
| 12 | 252285308 | MEDICAID | FLORIDA | |
| 13 | 252285309 | MEDICAID | FLORIDA | |
| 14 | 252285303 | MEDICAID | FLORIDA | |
| 15 | 252285311 | MEDICAID | FLORIDA | |
