MEDICARE: DR. HARISH M. MADNANI M.D.

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
1	207R00000X	Internal Medicine Physician	10220	MS
2	207R00000X	Internal Medicine Physician	ME98999	FL
3	174400000X	Specialist	10220	MS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00984684	OTHER	FL	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	P00984684	OTHER	FL	RR MCR
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	EW163Y	OTHER	FL	INTERNAL MEDICINE
6	14C9A	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1437182524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARISH M. MADNANI M.D.

Provider Business Mailing Address
First Line	:	5400 PINEHURST DR
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34606-3833
Country	:	US
Telephone Number	:	352-277-5348
Fax Number	:	352-606-2857

Provider Business Practice Location Address
First Line	:	13911 LAKESHORE BLVD
Second Line	:	#111
City	:	HUDSON
State	:	FL
Zip	:	34667-7102
Country	:	US
Telephone Number	:	727-869-8800
Fax Number	:	727-869-8814

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	12/05/2023

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