Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 11015103 | FL |
NPI | 1497426019 |
---|---|
Provider Name | Roshan Scaria |
First Address | Pembroke Pines, FL 33029-4218 |
Second Address | Miami, FL 33136-1003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2021 |
Last Update Date | 23/09/2021 |