Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | ME0037551 | FL |
NPI | 1023038494 |
---|---|
Provider Name | Dr. Surendra K Sirpal |
First Address | Lake Worth, FL 33462-1329 |
Second Address | Lake Worth, FL 33462-1329 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 28/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
065214800 | (05) | FL |
110100780 | RAILROAD MEDICARE (01) | |
C42030 | (02) |