Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0002X | Hospice and Palliative Medicine | 35.135935 | OH |
Y | 207RH0002X | Hospice and Palliative Medicine | ME38243 | FL |
NPI | 1356339170 |
---|---|
Provider Name | Mr. Peter Arthur Radice |
First Address | New Port Richey, FL 34653-4935 |
Second Address | New Port Richey, FL 34653-4935 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2005 |
Last Update Date | 11/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009982300 | (05) | FL |
30353 | FL BCBS (01) | FL |