Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | ME66128 | FL |
NPI | 1023002003 |
---|---|
Provider Name | Dr. David Robert Axline |
First Address | Naples, FL 34102-5820 |
Second Address | Naples, FL 34102-5820 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2005 |
Last Update Date | 10/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
25608A | BCBS (01) | FL |
25608X | MEDICARE (01) | FL |
376127400 | (05) | FL |
F14236 | (02) | FL |