Individual
EARL R DIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2 COLUMBIA DR, TAMPA, FL 33606-3508
(813) 844-7000
Mailing address
14050 NW 14TH ST, SUITE 190, SUNRISE, FL 33323-2865
(800) 424-3672
(954) 377-3042
Taxonomy
Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
ME71240
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
254054100
—
FL
01
—
43116
BLUE SHIELD OF FL
FL
Enumeration date
06/28/2006
Last updated
07/20/2010
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