Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | ME106826 | FL |
N | 208000000X | Pediatrician | ME106826 | FL |
NPI | 1134376536 |
---|---|
Provider Name | Dr. David J Rhodes |
First Address | Rockland, DE 19732-0191 |
Second Address | Orlando, FL 32827-7402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2008 |
Last Update Date | 08/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003427600 | (05) | FL |
14A60 | BCBS OF FLORIDA (01) | FL |