Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | ME0043269 | FL |
NPI | 1093874190 |
---|---|
Provider Name | Vijay Narayan Samant |
First Address | Boca Raton, FL 33427-3444 |
Second Address | Boca Raton, FL 33486 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 04/05/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
06882910 | (05) | FL |
D63845 | (02) |