Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | ME39676 | FL |
NPI | 1174503379 |
---|---|
Provider Name | Dr. Rand W. Altemose |
First Address | Fort Myers, FL 33916-2216 |
Second Address | Tampa, FL 33607-6214 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2006 |
Last Update Date | 23/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
066470700 | (05) | FL |
30350 | BCBS (01) | FL |
D82417 | (02) | |
P00727027 | RR MEDICARE (01) | FL |