Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 231868 | MA |
N | 111NI0900X | Internist | 231868 | MA |
Y | 207RP1001X | Pulmonary Disease | 149344 | FL |
N | 207RP1001X | Pulmonary Disease | 240050 | MA |
NPI | 1053578963 |
---|---|
Provider Name | Melissa Hoffman Tukey |
First Address | Orlando, FL 32891-0001 |
Second Address | Tampa, FL 33606-3571 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2008 |
Last Update Date | 21/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110364300 | (05) | FL |
FY2E9 | BLUE CROSS BLUE SHIELD (01) | FL |