Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | ME109930 | FL |
NPI | 1043428089 |
---|---|
Provider Name | Seetal Mewar |
First Address | Lake Worth, FL 33462-1304 |
Second Address | Lake Worth, FL 33462-1304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 17/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003635500 | (05) | FL |