Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME0038311 | FL |
N | 111NI0900X | Internist | ME0038311 | FL |
Y | 207RP1001X | Pulmonary Disease | ME0038311 | FL |
NPI | 1023004298 |
---|---|
Provider Name | Mr. Sivakumar V Amar |
First Address | Trinity, FL 34655-1811 |
Second Address | Trinity, FL 34655-1811 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2005 |
Last Update Date | 09/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0008754 | GHI (01) | |
066422700 | (05) | FL |
08754 | AETNA HUMANA (01) | |
102775 | AUMEND (01) | |
102775 | METRA HEALTH (01) | |
290014401 | RAILROAD MEDICARE (01) | |
51146 | BLUE CROSS BLUE SHIELD (01) | |
D21700 | (02) |