Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | ME 68335 | FL |
NPI | 1285627570 |
---|---|
Provider Name | Dr. Wendy V Sapolsky |
First Address | Jacksonville, FL 32204-3811 |
Second Address | Jacksonville, FL 32204-3811 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G08490 | (02) | FL |