Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | ME0077754 | FL |
NPI | 1518932896 |
---|---|
Provider Name | Thomas P San Giovanni |
First Address | Atlanta, GA 30384-0905 |
Second Address | Coral Gables, FL 33146-1174 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2006 |
Last Update Date | 02/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
47139 | BLUE CROSS BLUE SHIELD (01) | FL |