Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 1014 | ME |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | OS12968 | FL |
N | 207VG0400X | Gynecologist | 1014 | ME |
NPI | 1639148331 |
---|---|
Provider Name | James F Flaherty |
First Address | The Villages, FL 32162-2699 |
Second Address | The Villages, FL 32163-2039 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2006 |
Last Update Date | 28/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
030420 | ANTHEM (01) | |
1040562 | AETNA (01) | |
251470099 | (05) | ME |
B58073 | (02) |