Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 35.093498 | OH |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | MD.31765 | AL |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | ME117402 | FL |
NPI | 1699040444 |
---|---|
Provider Name | Kavita Iyengar |
First Address | Panama City, FL 32405-7605 |
Second Address | Panama City, FL 32405-7605 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2012 |
Last Update Date | 03/09/2013 |