Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | OS 12571 | FL |
NPI | 1407146301 |
---|---|
Provider Name | Mr. Sina Menashehoff |
First Address | Atlantis, FL 33462-6641 |
Second Address | Boca Raton, FL 33434-3988 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2011 |
Last Update Date | 03/05/2017 |