Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPC2730 | FL |
NPI | 1003944703 |
---|---|
Provider Name | Dr. Michael Zwolinski |
First Address | St Augustine, FL 32084-7307 |
Second Address | St Augustine, FL 32086-6072 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03492 | SPECTERA (01) | FL |
20566 | BLUE CROSS & BLUE SHIELD (01) | FL |
2784940 | AETNA (01) | FL |
410042741 | PALMETTO GBA (01) | FL |
593549151 | CIGNA (01) | FL |
593549151 | HUMANA (01) | FL |
593549151 | UNITED HEALTHCARE (01) | FL |
620958100 | (05) | FL |
U01775 | (02) | FL |