Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | ME88282 | FL |
NPI | 1003905605 |
---|---|
Provider Name | Dr. Sandra Maritza Jara |
First Address | Tampa, FL 33647-1858 |
Second Address | Tampa, FL 33647-1858 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 08/07/2007 |