Individual
SUMRA RATHORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5008 MUSTANG RD, JACKSONVILLE, FL 32216-6028
(904) 296-2350
(904) 296-8467
Mailing address
5008 MUSTANG RD, JACKSONVILLE, FL 32216-6028
(904) 887-9780
(904) 296-8467
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME 71280
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220032664
RAILROAD MEDICARE
FL
Enumeration date
05/02/2006
Last updated
09/23/2010
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