Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | TRN14669 | FL |
Y | 2080P0207X | Pediatric Hematology-Oncologist | ME117009 | FL |
NPI | 1275851982 |
---|---|
Provider Name | Vibhuti Agarwal |
First Address | Orlando, FL 32827-7884 |
Second Address | Orlando, FL 32827-7884 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2010 |
Last Update Date | 27/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201031 | (05) | AL |