MEDICARE: HARMINI K. SIDHU,PA.,INC.

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	122300000X	Dentist	DN9717	FL

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

General Provider Information

NPI Number	:	1588915060
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARMINI K. SIDHU,PA.,INC.

Provider Business Mailing Address
First Line	:	1315 E ROBINSON ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32801-2117
Country	:	US
Telephone Number	:	407-896-5656
Fax Number	:	407-897-6797

Provider Business Practice Location Address
First Line	:	1315 E ROBINSON ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32801-2117
Country	:	US
Telephone Number	:	407-896-5656
Fax Number	:	407-897-6797

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. HARMINI K. SIDHU
Credential	:	B.D.S.
Telephone Number	:	407-896-5656

Provider Enumeration Date	:	09/25/2012
Last Update Date	:	09/25/2012

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