Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | ME55240 | FL |
N | 2080A0000X | Adolescent Medicine | ME55240 | FL |
N | 2080P0006X | Developmental - Behavioral Pediatrician | ME55240 | FL |
NPI | 1194756031 |
---|---|
Provider Name | Stephen Commins |
First Address | Orlando, FL 32806 |
Second Address | Orlando, FL 32806 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
08674 | BCBS (01) | FL |
AC8824092 | DEA (01) | FL |
E68769 | (02) | FL |