Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | ME24683 | FL |
NPI | 1023073210 |
---|---|
Provider Name | Winfried H Hansen |
First Address | Pensacola, FL 32504-8145 |
Second Address | Pensacola, FL 32504-8145 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 21/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009946810 | (05) | AL |
054068400 | (05) | FL |
17297 | BLUE CROSS BLUE SHIELD (01) | FL |
183572197 | MEDICARE RAILROAD (01) | |
590-20227 | BLUE CROSS BLUE SHIELD (01) | AL |
C04149 | (02) |