Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | 593072246 | FL |
Y | 207X00000X | Orthopaedic Surgeon | 593072246 | FL |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 593072246 | FL |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 593072246 | FL |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 593072246 | FL |
NPI | 1457356701 |
---|---|
Provider Name | Dr. Steven Knezevich |
First Address | Tampa, FL 33624-1834 |
Second Address | Tampa, FL 33624-1834 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2005 |
Last Update Date | 12/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
056274200 | (05) | FL |
12696 | BLUE CROSS BLUE SHIELD (01) | FL |
593072246 | COMMERCIAL CARRIERS (01) | FL |
E94149 | (02) | FL |
ME0060554 | WORKERS COMPENSATION (01) | FL |