Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | ME30671 | FL |
N | 208600000X | Surgeon | ME30671 | FL |
N | 2086S0102X | Surgical Critical Care | ME30671 | FL |
Y | 2086S0127X | Trauma Surgeon | ME30671 | FL |
NPI | 1336107853 |
---|---|
Provider Name | James M Hurst |
First Address | Orlando, FL 32891-7770 |
Second Address | Tampa, FL 33606-3603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 14/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003280100 | (05) | FL |
15858 | BLUE CROSS BLUE SHIELD (01) | FL |