Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | OS7528 | FL |
N | 207XS0117X | Orthopaedic Spine Surgeon | OS7528 | FL |
NPI | 1275529455 |
---|---|
Provider Name | Vrej K Manoogian |
First Address | Mount Dora, FL 32757-2105 |
Second Address | Mount Dora, FL 32757-2105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2005 |
Last Update Date | 30/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200041567 | RAILROAD MEDICARE (01) | FL |
46883 | BLUE CROSS BLUE SHIELD FL (01) | FL |
DD9204 | RAILROAD MEDICARE GROUP (01) | FL |
G29207 | (02) | FL |