Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | TRN#11496 | FL |
Y | 2080P0202X | Pediatric Cardiologist | ME106603 | FL |
NPI | 1184827248 |
---|---|
Provider Name | Renata Luri Shih |
First Address | Orlando, FL 32891-8025 |
Second Address | Gainesville, FL 32610-3003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2007 |
Last Update Date | 15/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
008838200 | (05) | FL |