Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 16964 | AL |
Y | 2080P0208X | Pediatric Infectious Diseases | 16964 | AL |
NPI | 1659325116 |
---|---|
Provider Name | Benjamin Estrada |
First Address | Mobile, AL 36640-0480 |
Second Address | Mobile, AL 36604-3207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2006 |
Last Update Date | 02/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000088154 | (05) | AL |
00111730 | (05) | MS |
12-10131 | UNITED HEALTH CARE (01) | AL |
1991635 | (05) | LA |
255604900 | (05) | FL |
51088154 | BLUE CROSS (01) | AL |
51504520 | BCBS KPG (01) | AL |
F52634 | (02) | AL |