The health card is different from the tax code and is issued to those who reside in Italy;
The digital signature or service card, if regularly registered with Aire, can be requested and obtained immediately from the chambers of commerce but in Italy. If you have the national service card (CNS) and it is still active, you can easily activate the SPID with it without even needing to ask for an electronic identity card;
As an Italian citizen, if he has not renounced his citizenship, he can proceed with the request for the replacement of the CIC (PAPER IDENTITY CARD) with the CIE, which shows the tax code on the document by separating / duplicating the one on the Health Card. With the CIE, he will be able to fulfill the SPID registration and no longer need the CNS and so on. For citizens residing abroad registered with AIRE, the Electronic Identity Card can be requested at the relevant Consulate. To make it work you must have a card reader, like for the CNS, the cost of which varies from 15 to 30 euros or alternatively opt for a completely dematerialized solution but which requires an Italian telephone number;
As you know, the Health Card with indication of the regions and on the back the European e-111 model came into use in January 2004 but it has not annulled the legal value of the tax code previously issued on a mechanized paper model nor has it invalidated the green plastic card with magnetic strip, if you have them, keep them because they are valid to all intents and purposes;
The new card can be requested by sending the completed, signed and scanned model AA4/8 to the Agency’s office, also by e-mail, together with a copy of the identity document, even if, for citizens residing abroad outside the EU, it is possible to request the attribution of the tax code to the Italian diplomatic-consular representation in the country of residence by filling in the AA4/8 form.