Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | ME88929 | FL |
Y | 207RX0202X | Medical Oncology | ME88929 | FL |
NPI | 1376596346 |
---|---|
Provider Name | Magda Elkabani Melchert |
First Address | Fort Myers, FL 33916-2216 |
Second Address | Brandon, FL 33511-5962 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 16/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
275257300 | (05) | FL |
I56320 | (02) | FL |
P00727035 | RR MEDICARE (01) | FL |