Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | ME86268 | FL |
NPI | 1003961236 |
---|---|
Provider Name | Dr. Arun P Khazanchi |
First Address | Lakewood Ranch, FL 34202-2917 |
Second Address | Lakewood Ranch, FL 34202-2917 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2007 |
Last Update Date | 27/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H09068 | (02) | FL |