Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | ME38131 | FL |
NPI | 1043325582 |
---|---|
Provider Name | Paul Citrin |
First Address | Zephyrhills, FL 33542-7505 |
Second Address | Zephyrhills, FL 33542-7505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 30/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
048296000 | (05) | FL |
05940Y | TPA MEDICARE # (01) | FL |
770001050 | RR MEDICARE (01) | FL |
D47673 | (02) | FL |