Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | OS0003939 | FL |
NPI | 1013001387 |
---|---|
Provider Name | Robert Sculthorpe |
First Address | Plantation, FL 33318-7347 |
Second Address | Plantation, FL 33324 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 07/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
050030234 | MEDICARE RAILROAD (01) | |
062780100 | (05) | FL |
82230 | BCBS (01) | |
E32183 | (02) |