Individual
MISS CORINNE A RATHNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4623 FOREST HILL BLVD, SUITE 105, WEST PALM BEACH, FL 33415-7469
(561) 969-7900
(561) 969-7919
Mailing address
4623 FOREST HILL BLVD, SUITE 105, WEST PALM BEACH, FL 33415-7469
(561) 969-7900
(561) 969-7919
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9104800
FL
207R00000X
Internal Medicine Physician
9104800
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9104800
STATE LICENSE NUMBER
FL
Enumeration date
10/01/2009
Last updated
02/02/2010
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