Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | ME130266 | FL |
Y | 207RX0202X | Medical Oncology | ME130266 | FL |
NPI | 1003893199 |
---|---|
Provider Name | Dr. Amir Harandi |
First Address | Fort Myers, FL 33916-2216 |
Second Address | Bradenton, FL 34211-1291 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2005 |
Last Update Date | 11/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
019422400 | (05) | FL |