Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | ME130437 | FL |
NPI | 1114909272 |
---|---|
Provider Name | Robert Udelsman |
First Address | Atlanta, GA 30384-8054 |
Second Address | Miami, FL 33176-2118 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2005 |
Last Update Date | 13/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
020191900 | (05) | FL |
E38980 | (02) |