Individual
DR. SEPALIKA WASANTHALAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5053 SOUTH CONGRESS AVE, SUITE 201, ATLANTIS, FL 33462
(561) 357-9060
(561) 357-9460
Mailing address
460 PINE HOLLOW LN, WEST PALM BEACH, FL 33413-2255
(561) 684-6129
(561) 357-9460
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
ME0067628
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2451100200
—
FL
Enumeration date
09/20/2006
Last updated
09/17/2007
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