Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | ARNP9319863 | FL |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | F430251 | NY |
NPI | 1083700496 |
---|---|
Provider Name | Dr. Ponrathi Rosalind Athilingam |
First Address | Orlando, FL 32891-0001 |
Second Address | Tampa, FL 33612-6601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
022890200 | (05) | FL |
2C1HB | BLUE CROSS BLUE SHIELD (01) | FL |