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Individual
DR. FANOURIOS IACOVOS FERDERIGOS
Active
Individual
DR. FANOURIOS IACOVOS FERDERIGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME40703
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02051
WELLCARE PROVIDER NUMBER
FL
01
—
10015687
RAILROAD MEDICARE
FL
01
—
1573201020
CIGNA PROVIDER NUMBER
FL
01
—
15800Z
MEDICARE PTAN
FL
01
—
207845
AVMED PROVIDER NUMBER
FL
01
—
220139000
FEDERAL WORKERS COMP PROV
FL
01
—
4133544
AETNA PPO
FL
01
—
592745575001
CHAMPUS PROVIDER NUMBER
FL
01
—
624281
AETNA HMO
FL
Enumeration date
10/31/2005
Last updated
06/12/2015
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