Basic Information
Provider Information
NPI: 1366708083
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BANKS
FirstName: JAMES
MiddleName: S
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 7623
Address2:  
City: NAPLES
State: FL
PostalCode: 341017623
CountryCode: US
TelephoneNumber: 3057127229
FaxNumber: 3053971139
Practice Location
Address1: 20900 BISCAYNE BLVD
Address2:  
City: AVENTURA
State: FL
PostalCode: 331801407
CountryCode: US
TelephoneNumber: 3056827000
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/06/2012
LastUpdateDate: 07/05/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/05/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202XME124047FLY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

ID Information
IDTypeStateIssuerDescription
02180580005FL MEDICAID
1426431401FLCAQHOTHER
P0225268901FLFL RAILROAD MEDICAREOTHER
IZ989Y01FLFLORIDA MEDICAREOTHER
KJWW101FLFLORIDA BLUE (BCBS)OTHER


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