Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RR0500X | Rheumatology | 21360 | NE |
Y | 207RR0500X | Rheumatology | ME 97774 | FL |
NPI | 1003856659 |
---|---|
Provider Name | Dr. Brian Todd Mckinley |
First Address | Bradenton, FL 34209-3201 |
Second Address | Bradenton, FL 34209-3201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 27/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
281326200 | (05) | FL |
82147 | BCBS (01) | FL |
P00451169 | RAIL ROAD (01) | FL |