Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | ME78187 | FL |
NPI | 1003860883 |
---|---|
Provider Name | Sunita A Patil |
First Address | Orlando, FL 32806-1101 |
Second Address | Orlando, FL 32806-1101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 10/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
256660500 | (05) | FL |
ME78187 | MEDICAL LICENSE (01) | FL |