Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | ME 99967 | FL |
Y | 207RP1001X | Pulmonary Disease | ME 99967 | FL |
N | 207RS0012X | Sleep Medicine | ME 99967 | FL |
NPI | 1053356964 |
---|---|
Provider Name | Raymond Santucci II |
First Address | Fort Myers, FL 33907-1410 |
Second Address | Fort Myers, FL 33908-5101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2006 |
Last Update Date | 29/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11336 | BCBS OF FL (01) | FL |
2613158 | (05) | OH |
280282100 | (05) | FL |
313574 | AVMED (01) | FL |
7544875 | AETNA (01) | FL |
9455421 | CIGNA (01) | FL |
990635 | WELLCARE (01) | FL |
H78221 | (02) | OH |
P01319839 | RR MEDICARE (01) | FL |
P203272 | OPTIMUM (01) | FL |
P305702 | FREEDOM (01) | FL |