Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | ME68735 | FL |
NPI | 1265420020 |
---|---|
Provider Name | Dr. Elena Zelmanovich Kruglyak |
First Address | Fort Myers, FL 33907-1412 |
Second Address | Boca Raton, FL 33428-2231 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2005 |
Last Update Date | 06/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1255024 | WELLCARE (01) | FL |
252889 | AVMED (01) | FL |
264956000 | (05) | FL |
27290 | BCBS (01) | FL |
5475027 | AETNA (01) | FL |
6550599 | CIGNA (01) | FL |
6664 | DIMENSION HEALTH (01) | FL |
DELRAY456 | RR MEDICARE (01) | FL |
G12022 | (02) | FL |
P1001984 | FREEDOM (01) | FL |
P954880 | OPTIMUM (01) | FL |
QMP000003849305 | MOLINA (01) | FL |