Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | ME96774 | FL |
NPI | 1154402816 |
---|---|
Provider Name | Dr. Jaspreet Kaur Pestana |
First Address | Orlando, FL 32891-0001 |
Second Address | Tampa, FL 33613 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 26/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H73117 | (02) |