Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 0116018660 | VA |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | ME124295 | FL |
NPI | 1134379423 |
---|---|
Provider Name | Mrs. Sarah Gloria Obican |
First Address | Orlando, FL 32891-7770 |
Second Address | Tampa, FL 33606-3603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2008 |
Last Update Date | 20/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
015358200 | (05) | FL |
150ZZ | BLUE CROSS BLUE SHIELD (01) | FL |