1740627892 NPI number — MISS NALINI ANANDJIWALA MD

Table of content: MISS NALINI ANANDJIWALA MD (NPI 1740627892)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740627892 NPI number — MISS NALINI ANANDJIWALA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANANDJIWALA
Provider First Name:
NALINI
Provider Middle Name:
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740627892
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/30/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7765 COUNTY ROAD 231 RECEPTION MEDICAL CENTER
Provider Second Line Business Mailing Address:
FLORIDA DEPARTMENT OF CORRECTIONS
Provider Business Mailing Address City Name:
LAKE BUTLER
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32054
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
386-496-6000
Provider Business Mailing Address Fax Number:
386-496-6907

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7765 COUNTY RD 231
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAKE BUTLER
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
386-496-6134
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/30/2013

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: 208D00000X , with the licence number:  ME48784 , 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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