Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | ME38051 | FL |
NPI | 1437131794 |
---|---|
Provider Name | Dr. Anthony Kriseman |
First Address | Tampa, FL 33606-2918 |
Second Address | St Petersburg, FL 33701-4804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2005 |
Last Update Date | 18/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
046587900 | (05) | FL |
D54178 | (02) | FL |