Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | OS0005705 | FL |
NPI | 1477529360 |
---|---|
Provider Name | Dr. Chitto P Sarkar |
First Address | Port St Lucie, FL 34952-2322 |
Second Address | Port St Lucie, FL 34952-2322 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2006 |
Last Update Date | 19/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
050862400 | (05) | FL |
E23655 | (02) | FL |