Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | ME136660 | FL |
NPI | 1346534948 |
---|---|
Provider Name | Kavita Desai Khanijow |
First Address | Rockledge, FL 32955-4306 |
Second Address | Trinity, FL 34655-4421 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2011 |
Last Update Date | 16/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
N7668 | HF MEDICARE (01) | FL |