Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | 99-00520 | NC |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 99-00520 | NC |
NPI | 1124102033 |
---|---|
Provider Name | Sridharan Gururangan |
First Address | Gainesville, FL 32610-0265 |
Second Address | Gainesville, FL 32610-0371 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 19/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
016336200 | (05) | FL |
F73173 | (02) |