Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 11015250A | IN |
Y | 204F00000X | Transplant Surgeon | ME115700 | FL |
NPI | 1144532680 |
---|---|
Provider Name | Thiago Beduschi |
First Address | Gainesville, FL 32610-0286 |
Second Address | Gainesville, FL 32610-1005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2010 |
Last Update Date | 15/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
008598100 | (05) | FL |