1750498424 NPI number — DR. RALPH W REED DPM

Table of content: DR. RALPH W REED DPM (NPI 1750498424)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750498424 NPI number — DR. RALPH W REED DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REED
Provider First Name:
RALPH
Provider Middle Name:
W
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
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:
1750498424
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/02/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
575 AVENUE K SE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WINTER HAVEN
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33880-4215
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
863-293-1950
Provider Business Mailing Address Fax Number:
293-293-1899

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
575 AVENUE K SE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WINTER HAVEN
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33880-4215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
863-293-1950
Provider Business Practice Location Address Fax Number:
863-293-1899
Provider Enumeration Date:
08/25/2006

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: 213E00000X , with the licence number:  PO675 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 480028215 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 87292 . This is a "BC BS FL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1318640001 . This is a "DME PALMETTO" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1750498424 . This is a "INDIV NPI" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1043321763 . This is a "GROUP NPI" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: K0339 . This is a "MEDICARE GROUP #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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