Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | PO1764 | FL |
NPI | 1023009875 |
---|---|
Provider Name | Mr. Michael R Cook |
First Address | Miami, FL 33176-2264 |
Second Address | Miami, FL 33176-2264 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2005 |
Last Update Date | 14/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
052072100 | (05) | FL |
4055390001 | DMERC (01) | FL |
4355616 | AETNA (01) | FL |
447744 | UNITED HEALTHCARE (01) | FL |
480029345 | RAILROAD MEDICARE (01) | FL |
7380395 | CIGNA (01) | FL |
87977 | BCBS (01) | FL |
T55631 | (02) | FL |