Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | ME0061208 | FL |
Y | 208600000X | Surgeon | ME0061208 | FL |
NPI | 1013920057 |
---|---|
Provider Name | Dr. Eric C. Borock |
First Address | Clearwater, FL 33757-8744 |
Second Address | New Port Richey, FL 34653-2612 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 17/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
056978000 | (05) | FL |
E94607 | (02) | FL |
P00780614 | RAILROAD MEDICARE PROVIDER NUMBER (01) | FL |