Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 01029193A | IN |
NPI | 1124085014 |
---|---|
Provider Name | Dr. Vijaykumar C Amin |
First Address | Rockledge, FL 32955-6026 |
Second Address | Rockledge, FL 32955-6026 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 20/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D69736 | (02) | IN |