Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | ME0071023 | FL |
Y | 2080P0214X | Pediatric Pulmonologist | ME71023 | FL |
NPI | 1104839497 |
---|---|
Provider Name | Carlos E Sabogal |
First Address | Orlando, FL 32806-1101 |
Second Address | Orlando, FL 32806-1101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 16/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
251065100 | (05) | FL |
BS4981367 | DEA (01) | FL |
ME71023 | MEDICAL LICENSE (01) | FL |