Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | ME95424 | FL |
NPI | 1235338765 |
---|---|
Provider Name | Rajesh Nair |
First Address | Orlando, FL 32806-2134 |
Second Address | Orlando, FL 32806-2134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2007 |
Last Update Date | 28/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
279004100 | (05) | FL |
ME95424 | MEDICAL LICENSE (01) | FL |