Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | ME94370 | FL |
Y | 207RP1001X | Pulmonary Disease | ME94370 | FL |
NPI | 1053378240 |
---|---|
Provider Name | Sunil Pammi |
First Address | Fort Myers, FL 33902-2147 |
Second Address | Fort Myers, FL 33912-4462 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 29/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
274034600 | (05) | FL |
30771 | BCBS (01) | FL |
I05318 | (02) | |
P00292827 | RAILROAD MEDICARE (01) | FL |