Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 43315 | AZ |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | DR.0055533 | CO |
Y | 207YP0228X | Pediatric Otolaryngology | ME134358 | FL |
NPI | 1720212244 |
---|---|
Provider Name | Dr. Sergio S Cervantes |
First Address | Jacksonville, FL 32256-0532 |
Second Address | Orlando, FL 32827-7402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2009 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
023371000 | (05) | FL |
142108500 | (05) | WY |
19676336 | (05) | CO |