Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | OS8158 | FL |
NPI | 1003869504 |
---|---|
Provider Name | Habib H. Karkavandian |
First Address | Tampa, FL 33626-4712 |
Second Address | Tampa, FL 33626-1732 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 04/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G70880 | (02) |