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 | 207RG0100X | Internal Medicine | Gastroenterology | OS3688 | 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 | 591273247 | OTHER | | UHC EMPIRE PLAN |
| 2 | 10311 | OTHER | FLORIDA | FLORIDA WELLCARE (MEDICARE PLAN) |
| 3 | 212910 | OTHER | FLORIDA | AVMED |
| 4 | 3131464 | OTHER | FLORIDA | CIGNA PPO/HMO, OPEN ACCESS, AND GREATWEST |
| 5 | 388452 | OTHER | FLORIDA | UNITED HEALTHCARE COMMERCIAL AND MEDICARE PLANS |
| 6 | 82099 | OTHER | FLORIDA | BLUE OPTIONS, BLUE CHOICE, FEDERAL, FLORIDA STATE AND TRADITIONAL BCBS |
| 7 | 710665 | OTHER | | MAIL HANDLERS BENEFIT PLAN (MHBP) |
| 8 | 10311 | OTHER | FLORIDA | FLORIDA HEALTHEASE |
| 9 | 119461500 | MEDICAID | FLORIDA | |
| 10 | 82099 | OTHER | FLORIDA | OUT OF STATE BLUE CROSS BLUE SHIELD |
| 11 | 82099 | OTHER | FLORIDA | BCBS BLUE CARE, ADVANTAGE 65 SELECT, MEDICARE PPO/HMO, GO BLUE |
| 12 | 100005888 | OTHER | | RAILROAD MEDICARE |
| 13 | 10311 | OTHER | FLORIDA | FLORIDA STAYWELL |
