Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | P9568 | TX |
Y | 2080N0001X | Neonatal-Perinatal Doctor | ME132167 | FL |
NPI | 1003108614 |
---|---|
Provider Name | Dr. Steven Lee Ford |
First Address | Orlando, FL 32891-0001 |
Second Address | Tampa, FL 33606-3603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2011 |
Last Update Date | 26/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
021115200 | (05) | FL |
2IWTE | BLUE CROSS BLUE SHIELD (01) | FL |