Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | ME103910 | FL |
N | 207W00000X | Ophthalmologist | P21410 | MD |
NPI | 1003952466 |
---|---|
Provider Name | Mr. Anup Kubal |
First Address | Plantation, FL 33322-5223 |
Second Address | Jupiter, FL 33458-3030 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 14/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001349500 | (05) | FL |