1134395890 NPI number — DR. PARMINDER SINGH MAHAL M.D.

Table of content: DR. PARMINDER SINGH MAHAL M.D. (NPI 1134395890)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134395890 NPI number — DR. PARMINDER SINGH MAHAL M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAHAL
Provider First Name:
PARMINDER
Provider Middle Name:
SINGH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SINGH
Provider Other First Name:
PARMINDER
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1134395890
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/27/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
50 CYPRESS POINT PKWY
Provider Second Line Business Mailing Address:
SUITE A3
Provider Business Mailing Address City Name:
PALM COAST
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32164-2500
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
386-445-0977
Provider Business Mailing Address Fax Number:
386-445-0579

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
50 CYPRESS POINT PKWY
Provider Second Line Business Practice Location Address:
SUITE A3
Provider Business Practice Location Address City Name:
PALM COAST
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32164-2500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
386-445-0977
Provider Business Practice Location Address Fax Number:
386-445-0579
Provider Enumeration Date:
05/02/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  ME101528 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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