Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | ME60401 | FL |
Y | 2080P0208X | Pediatric Infectious Diseases | ME60401 | FL |
NPI | 1245299320 |
---|---|
Provider Name | Dr. Mobeen Hasan Rathore |
First Address | Jacksonville, FL 32231-4008 |
Second Address | Jacksonville, FL 32209-6511 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2006 |
Last Update Date | 01/07/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000468069C | (05) | GA |
0550540-00 | (05) | FL |
370017074 | RAILROAD MEDICARE (01) | FL |
E65938 | (02) | FL |