Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | ME82428 | FL |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | ME82428 | FL |
NPI | 1295707230 |
---|---|
Provider Name | Tarek Gamal Garas |
First Address | Lakeland, FL 33805-3019 |
Second Address | Lakeland, FL 33805-3109 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2006 |
Last Update Date | 22/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H63522 | (02) |