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NPI Code Detail

MEDICARE: KANWALJIT K SIDHU APRN

MEDICARE:   KANWALJIT K SIDHU  APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAPRN9438337FL
2363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN9438337FL

General Provider Information

NPI Number : 1134475627
Entity Type Code : Individual
Provider Name (Legal Business Name) : KANWALJIT K SIDHU APRN
Provider Business Mailing Address
First Line : 2595 TAMPA RD STE C
Second Line :
City : PALM HARBOR
State : FL
Zip : 34684-3130
Country : US
Telephone Number : 630-849-8756
Fax Number :
Provider Business Practice Location Address
First Line : 2595 TAMPA RD STE C
Second Line :
City : PALM HARBOR
State : FL
Zip : 34684-3130
Country : US
Telephone Number : 630-849-8756
Fax Number : 727-382-1382
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2012
Last Update Date : 03/24/2025

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Directions to “ KANWALJIT K SIDHU APRN” Practice Location

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