Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | ME45372 | FL |
NPI | 1053322180 |
---|---|
Provider Name | Frank W Walsh |
First Address | Orlando, FL 32891-7770 |
Second Address | Tampa, FL 33612-4742 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 19/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
035493700 | (05) | FL |
08657 | BLUE CROSS BLUE SHIELD (01) | FL |
E22576 | (02) | FL |