Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | ME43069 | FL |
NPI | 1235129347 |
---|---|
Provider Name | Dr. James Vincent Fiorica |
First Address | Orlando, FL 32886-3407 |
Second Address | Sarasota, FL 34239-3605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2005 |
Last Update Date | 24/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
041506500 | (05) | FL |
30787 | BCBS (01) | FL |
D85573 | (02) | FL |