Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | 20018 | SC |
Y | 207RH0003X | Hematology & Oncology | 2017-01930 | NC |
N | 207RH0003X | Hematology & Oncology | ME84216 | FL |
N | 207RX0202X | Medical Oncology | ME84216 | FL |
NPI | 1023040094 |
---|---|
Provider Name | Caio Max S Rocha Lima |
First Address | Winston Salem, NC 27157-0001 |
Second Address | Winston Salem, NC 27157-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 21/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2607743-00 | (05) | FL |
E5241 | (02) | FL |
G62926 | (02) | |
P01777687 | RAILROAD MEDICARE (01) | SC |
SC46704746 | MEDICARE PIN (01) | SC |
T41540 | (05) | SC |