Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | ME79719 | FL |
NPI | 1043274152 |
---|---|
Provider Name | Ketan A Kapadia |
First Address | Oxford, FL 34484-2951 |
Second Address | St Petersburg, FL 33710-1925 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 20/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G98161 | (02) |