Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | ME0050298 | FL |
NPI | 1043307762 |
---|---|
Provider Name | Natvarlal H Dalsania |
First Address | Merritt Island, FL 32953 |
Second Address | Merritt Island, FL 32953 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 10/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
064219300 | (05) | FL |
D20991 | (02) |