Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | CH10323 | FL |
NPI | 1356347256 |
---|---|
Provider Name | Dr. Benoit O Choiniere |
First Address | Clearwater, FL 33756-2236 |
Second Address | Clearwater, FL 33756-2236 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2005 |
Last Update Date | 05/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000389115 | BLUE CROSS / BLUE SHIELD (01) | IN |
000000532963 | BLUE CROSS / BLUE SHIELD (01) | IN |
P00330677 | RAILROAD MEDICARE (01) | IN |
T34999 | (02) | IN |