Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | ME106746 | FL |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | ME106746 | FL |
NPI | 1598712168 |
---|---|
Provider Name | Bela Ilya Kudish |
First Address | Gotha, FL 34734-0402 |
Second Address | Kissimmee, FL 34741 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2006 |
Last Update Date | 18/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I15241 | (02) | MI |