1881975019 NPI number — ELLIOT E. CAZES MD, NEW TAMPA OB-GYN, PA

Table of content: (NPI 1881975019)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881975019 NPI number — ELLIOT E. CAZES MD, NEW TAMPA OB-GYN, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ELLIOT E. CAZES MD, NEW TAMPA OB-GYN, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1881975019
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/04/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14424 BRUCE B DOWNS BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33613
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-977-2757
Provider Business Mailing Address Fax Number:
813-977-6639

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14424 BRUCE B DOWNS BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33613-2612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-977-2757
Provider Business Practice Location Address Fax Number:
813-977-6639
Provider Enumeration Date:
09/01/2011

Additional Information

Authorized Official

Authorized Official Last Name:
CAZES
Authorized Official First Name:
ELLIOT
Authorized Official Middle Name:
E
Authorized Official Title or Position:
DOCTOR
Authorized Official Telephone Number:
813-977-2757

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  ME 67876 , 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: 26834R . This is a "MEDICARE ID TYPE UNSPECIFIED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 377511900 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 016100700 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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