Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | ME87944 | FL |
Y | 207KA0200X | Allergist | ME87944 | FL |
NPI | 1578517009 |
---|---|
Provider Name | Sanjay Swami |
First Address | Jacksonville, FL 32256-8101 |
Second Address | Jacksonville, FL 32256-9179 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2006 |
Last Update Date | 14/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H67469 | (02) | FL |