Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | DN 19955 | FL |
Y | 213EG0000X | General Practice | DN 19955 | FL |
NPI | 1003166273 |
---|---|
Provider Name | Reetane Singh |
First Address | Fort Myers, FL 33966 |
Second Address | Fort Myers, FL 33966 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2012 |
Last Update Date | 14/09/2012 |