Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | ME135445 | FL |
NPI | 1013143189 |
---|---|
Provider Name | Vishwas Vanar |
First Address | Winter Garden, FL 34787-5050 |
Second Address | Winter Garden, FL 34787-5050 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2009 |
Last Update Date | 15/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
025176800 | (05) | FL |