Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | ME44954 | FL |
NPI | 1104875889 |
---|---|
Provider Name | Setty G Viralam |
First Address | Coral Gables, FL 33133-4841 |
Second Address | Coral Gables, FL 33146-2423 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2006 |
Last Update Date | 24/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
049998600 | (05) | FL |
D84793 | (02) |