Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | ME93030 | FL |
N | 208600000X | Surgeon | ME93030 | FL |
N | 2086S0105X | Surgery of the Hand | ME93030 | FL |
Y | 2086S0122X | Plastic and Reconstructive Surgery | ME93030 | FL |
NPI | 1932145323 |
---|---|
Provider Name | Dr. Eric Isaac Egozi |
First Address | Clearwater, FL 33755 |
Second Address | Clearwater, FL 33755 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 05/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
276446600 | (05) | FL |
28794 | BCBS (01) | FL |
613486900 | US DEPT 0F LABOR (01) | FL |
I40228 | (02) |