Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | ME91110 | FL |
Y | 2080P0214X | Pediatric Pulmonologist | ME91110 | FL |
NPI | 1316038466 |
---|---|
Provider Name | Dr. John M Prpich II |
First Address | Tampa, FL 33684-1637 |
Second Address | Tampa, FL 33603-2603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 16/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
280667300 | (05) | FL |
BP7406083 | DEA (01) | FL |