Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME145648 | FL |
N | 111NI0900X | Internist | ME145648 | FL |
N | 207RH0000X | Hematologist | ME145648 | FL |
N | 207RH0003X | Hematology & Oncology | 036-135338 | IL |
Y | 207RX0202X | Medical Oncology | ME145648 | FL |
NPI | 1407012602 |
---|---|
Provider Name | Swati Pathak |
First Address | Fort Myers, FL 33916-2216 |
Second Address | Davenport, FL 33837-5901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2008 |
Last Update Date | 15/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036135338 | (05) | IL |