Provider Demographics
NPI:1629015102
Name:HUME, RODERICK F (MD FACOG)
Entity Type:Individual
Prefix:
First Name:RODERICK
Middle Name:F
Last Name:HUME
Suffix:
Gender:M
Credentials:MD FACOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 CENTERVILLE RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4647
Mailing Address - Country:US
Mailing Address - Phone:850-431-3360
Mailing Address - Fax:850-431-3370
Practice Address - Street 1:1401 CENTERVILLE RD
Practice Address - Street 2:SUITE 400
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4647
Practice Address - Country:US
Practice Address - Phone:850-431-3360
Practice Address - Fax:850-431-3370
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301062537207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPENDINGMedicaid
FLC84633Medicare UPIN
FLDK589ZMedicare Oscar/Certification