Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | ME91080 | FL |
Y | 207RX0202X | Medical Oncology | ME91080 | FL |
NPI | 1013002880 |
---|---|
Provider Name | Padmaja Sai |
First Address | Fort Myers, FL 33916-2216 |
Second Address | Palm Coast, FL 32164-5999 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 01/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
117920 | (02) | FL |
U3514 | (02) |