Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | ME57619 | FL |
NPI | 1164427878 |
---|---|
Provider Name | Seth I Gasser |
First Address | Temple Terrace, FL 33637-0925 |
Second Address | Temple Terrace, FL 33637-0925 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2005 |
Last Update Date | 12/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1395394 | CIGNA (01) | FL |
18833 | BCBS OF FL (01) | FL |
200029276 | MEDICARE RR (01) | FL |
206908 | AVMED (01) | FL |
374934700 | (05) | FL |
4241380 | AETNA (01) | FL |
F11456 | (02) | FL |