Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | ME 83590 | FL |
NPI | 1013956473 |
---|---|
Provider Name | Dr. Lalbahadur S Nagabhairu |
First Address | Mount Dora, FL 32756-1077 |
Second Address | Mount Dora, FL 32757-2824 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
263334500 | (05) | FL |
H07501 | (02) |