Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | FL90643 | FL |
NPI | 1184671208 |
---|---|
Provider Name | Rahul Vinod Deshmukh |
First Address | Jacksonville, FL 32216-8070 |
Second Address | Jacksonville, FL 32256-5003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2006 |
Last Update Date | 25/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
48008Z | (02) | FL |
P00144027 | RAILROAD MEDICARE (01) | FL |