Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MT204679 | PA |
N | 111NI0900X | Internist | MT204679 | PA |
N | 207RH0000X | Hematologist | ME140219 | FL |
Y | 207RX0202X | Medical Oncology | ME140219 | FL |
NPI | 1417394149 |
---|---|
Provider Name | Shekeab Jauhari |
First Address | Fort Myers, FL 33916-2216 |
Second Address | Lake Mary, FL 32746-2115 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2013 |
Last Update Date | 13/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103740900 | (05) | FL |