Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | ME132739 | FL |
NPI | 1003115478 |
---|---|
Provider Name | Dr. Nirmal Shyam Sharma |
First Address | Orlando, FL 32891-7770 |
Second Address | Tampa, FL 33606-3603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2011 |
Last Update Date | 19/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
021490100 | (05) | FL |
IBYBP | BLUE CROSS BLUE SHIELD (01) | FL |