Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | ME 111704 | FL |
N | 2080P0205X | Pediatric Endocrinologist | 035639 | CT |
Y | 2080P0205X | Pediatric Endocrinologist | ME 111704 | FL |
N | 2080P0205X | Pediatric Endocrinologist | ME111704 | FL |
NPI | 1053394262 |
---|---|
Provider Name | Scott Andrews Rivkees |
First Address | Orlando, FL 32891-8025 |
Second Address | Gainesville, FL 32610-3003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2005 |
Last Update Date | 05/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001356395 | (05) | CT |
004391900 | (05) | FL |
D87796 | (02) |