Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0300X | Geriatric Medicine | 179063 | NY |
N | 207RG0300X | Geriatric Medicine | ME 125740 | FL |
N | 207RH0002X | Hospice and Palliative Medicine | 179063 | NY |
Y | 207RH0002X | Hospice and Palliative Medicine | ME 125740 | FL |
NPI | 1194895243 |
---|---|
Provider Name | Tanveer P Mir |
First Address | Orlando, FL 32804-4603 |
Second Address | Orlando, FL 32804-4603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 09/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F73069 | (02) | NY |