Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | ME109742 | FL |
Y | 2080P0208X | Pediatric Infectious Diseases | ME109742 | FL |
NPI | 1558652248 |
---|---|
Provider Name | Silvana B. Carr |
First Address | Orlando, FL 32891-7770 |
Second Address | Tampa, FL 33612-3803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2011 |
Last Update Date | 09/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003494800 | (05) | FL |
14CY4 | BLUE CROSS BLUE SHIELD (01) | FL |