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Organization

SANJIV WALIA MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SANJIV WALIA M.D. (PRESIDENT)
(772) 466-1977
Entity
Organization

Contact information

Practice address
2215 NEBRASKA AVE, SUITE 1F2, FORT PIERCE, FL 34950-4864
(772) 466-1977
(772) 466-2433
Mailing address
2215 NEBRASKA AVE, SUITE 1F2, FORT PIERCE, FL 34950-4864
(772) 466-1977
(772) 466-2433

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
ME0042047
FL

Other

Enumeration date
11/15/2011
Last updated
11/15/2011
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