Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | ME0068635 | FL |
NPI | 1023011129 |
---|---|
Provider Name | Dr. John F Kirk |
First Address | St. Petersburg, FL 33711-1142 |
Second Address | St. Petersburg, FL 33711-1142 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2005 |
Last Update Date | 01/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
070008232 | RAILROAD MEDICARE NUMBER (01) | FL |
27288 | BCBS PROVIDER NUMBER (01) | FL |
593313537 | TRICARE (01) | FL |
G07599 | (02) | FL |