Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | ME118539 | FL |
NPI | 1063557940 |
---|---|
Provider Name | Rizwana Fareeduddin |
First Address | Gainesville, FL 32605-4381 |
Second Address | Gainesville, FL 32605-4381 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2007 |
Last Update Date | 11/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
ME118539 | FLORIDA MEDICAL LICENSE (01) | FL |