Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | ME142193 | FL |
NPI | 1124063904 |
---|---|
Provider Name | Dr. Gundars Janis Katlaps |
First Address | Orlando, FL 32891-0001 |
Second Address | Tampa, FL 33606-3601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2006 |
Last Update Date | 31/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
104055100 | (05) | FL |
125387 | (02) | VA |
55DXU | BLUE CROSS BLUE SHIELD (01) | FL |