Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | ME0051093 | FL |
NPI | 1124086699 |
---|---|
Provider Name | Dr. Caryn G Hasselbring |
First Address | Orlando, FL 32806-8549 |
Second Address | Orlando, FL 32806-8549 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 12/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
046298500 | (05) | FL |
D50982 | (02) | FL |