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Shivam
Shivam
Upadhyaya
Medical doctor
Stuart, United States
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Florida Health Care Practitioner Data Portal
Full name
Shivam Upadhyaya
Job Title
Medical Doctor
Location
Stuart, FL, USA
LIC ID
160615
Current License Expiration Date
31/01/2026
Original Date
12/04/2022
Professional Rank Code
ME
Effective Date
12/04/2022
Board Action Indicator
N
License Status Description
CLEAR
License Active Status Description
ACTIVE
Country Description
MARTIN
Mailing Address Line 2
Suite 400
Practice Location Address Line 1
1050 SE Monterey Road
Practice Location Address Line 2
Suite 400
Practice Location Address City
STUART
Practice Location Address State
FL
Practice Location Address Zipcode
34994
Mode Code
Dispensing Practitioner
Prescribing Indicator
N
Dispensing Indicator
Y
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