Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | CH12092 | FL |
NPI | 1437774460 |
---|---|
Provider Name | Emily Rose Kalambaheti |
First Address | Orlando, FL 32826-4741 |
Second Address | Orlando, FL 32826-4741 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2020 |
Last Update Date | 16/06/2020 |