Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | DTP385 | FL |
NPI | 1326004813 |
---|---|
Provider Name | Dr. Indraneel Bhattacharyya |
First Address | Orlando, FL 32891-8025 |
Second Address | Gainesville, FL 32610-3003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2006 |
Last Update Date | 30/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
076003000 | (05) | FL |
BB 5738729 | DEA (01) | FL |
U 68839 | (02) | FL |
U68839 | (02) |