Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2003-0134 | NM |
N | 111NI0900X | Internist | 2003-0134 | NM |
N | 207RC0000X | Internist - Cardiovascular Disease | ME92434 | FL |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | ME92434 | FL |
NPI | 1174748396 |
---|---|
Provider Name | Dr. Sidney Peykar |
First Address | Punta Gorda, FL 33951-0363 |
Second Address | Port Charlotte, FL 33952-5002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2007 |
Last Update Date | 03/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H86447 | (02) | NM |