Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | ME118889 | FL |
NPI | 1083893010 |
---|---|
Provider Name | Rohit Vasan |
First Address | Orlando, FL 32891-7770 |
Second Address | Tampa, FL 33612-6601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2007 |
Last Update Date | 04/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
014681800 | (05) | FL |
14Y85 | BLUE CROSS BLUE SHIELD (01) | FL |