Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | ME 78486 | FL |
NPI | 1013900448 |
---|---|
Provider Name | Ronnie Sabbah |
First Address | Leesburg, FL 34748-6013 |
Second Address | Leesburg, FL 34748-6013 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2005 |
Last Update Date | 31/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
256970100 | (05) | FL |
46873 | BCBS (01) | FL |
G93339 | (02) | FL |