Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | ME67855 | FL |
NPI | 1043302383 |
---|---|
Provider Name | Barry F Blitz |
First Address | Fort Myers, FL 33907-1412 |
Second Address | Fort Myers, FL 33908-5193 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 10/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1109469 | WELLCARE (01) | FL |
255953 | AVMED PROVIDER # (01) | FL |
26774 | BCBS PROVIDER # (01) | FL |
4625452 | AETNA PROVIDER # (01) | FL |
7056360 | CIGNA PROVIDER # (01) | FL |
G01096 | (02) | FL |
P00426272 | RAILROAD MEDICARE (01) | FL |
P01808673 | CLEAR HEALTH ALLIANCE (01) | FL |