1700824794 NPI number — VLADIMIR IOFFE MD

Table of content: VLADIMIR IOFFE MD (NPI 1700824794)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700824794 NPI number — VLADIMIR IOFFE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
IOFFE
Provider First Name:
VLADIMIR
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700824794
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/27/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2234 COLONIAL BLVD
Provider Second Line Business Mailing Address:
ATTN: PAYER CONTRACTING & RELATIONS
Provider Business Mailing Address City Name:
FORT MYERS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33907-1412
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
239-931-7342
Provider Business Mailing Address Fax Number:
239-931-7385

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7503 GREENWAY CENTER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENBELT
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20770-3508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-446-3540
Provider Business Practice Location Address Fax Number:
301-446-3543
Provider Enumeration Date:
06/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0001X , with the licence number:  D0063835 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2085R0001X , with the licence number: C1-0007945 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0001X , with the licence number: MD445025 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0007 . This is a "CAREFIRST BCBS" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 01417951 . This is a "AMERIGROUP (PRINCE GEORGES)" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 217025ZE8Y . This is a "MEDICARE (PRINCE GEORGES)" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 3537067000 . This is a "AMERIHEALTH PROVIDER #" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 644416-01 . This is a "CAREFIRST BCBS REND. #" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 6882-0007 . This is a "CAREFIRST BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 7839775 . This is a "AETNA - PRINCE GEORGES" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: P00946714 . This is a "RAILROAD MEDICARE - PRINCE GEORGES" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 881027-01 . This is a "CARFIRST BCBS - PRINCE GEORGES" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 010283574 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1142647 . This is a "AMERIGROUP" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 7839775 . This is a "AETNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 072097600 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7839775 . This is a "AETNA KATIN/BERLIN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 88855704 . This is a "CAREFIRST BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 103542 . This is a "JOHN HOPKINS PROV. #" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 410729200 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8871421 . This is a "CIGNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: P01127674 . This is a "RAILROAD MCR- HARFORD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com