Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | ME53812 | FL |
Y | 207RA0401X | Internist - Addiction Medicine | ME53812 | FL |
NPI | 1619037074 |
---|---|
Provider Name | Abbas Sina |
First Address | Riverview, FL 33569 |
Second Address | Riverview, FL 33569 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2006 |
Last Update Date | 18/04/2018 |