Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 35089317 | OH |
N | 208200000X | Surgeon | 35089317 | OH |
N | 208600000X | Surgeon | 35089317 | OH |
Y | 208200000X | Surgeon | ME114536 | FL |
Y | 208600000X | Surgeon | ME114536 | FL |
NPI | 1790740041 |
---|---|
Provider Name | Dr. Santosh Potdar |
First Address | Brooksville, FL 34601-8925 |
Second Address | Spring Hill, FL 34609-0220 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 11/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001623400 | (05) | FL |
009381000 | (05) | FL |