MEDICARE: AMIT NANAVATI MD

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	207RI0011X	Interventional Cardiology Physician	MD442447	PA
2	207RI0011X	Interventional Cardiology Physician	ME127733	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	:	1932373479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMIT NANAVATI MD

Provider Business Mailing Address
First Line	:	61 MEMORIAL MEDICAL PKWY STE 3816
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32164-5982
Country	:	US
Telephone Number	:	386-586-1720
Fax Number	:	386-586-5422

Provider Business Practice Location Address
First Line	:	61 MEMORIAL MEDICAL PKWY STE 3816
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32164-5982
Country	:	US
Telephone Number	:	386-586-4765
Fax Number	:	386-586-4769

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

Provider Enumeration Date	:	04/16/2008
Last Update Date	:	04/15/2024

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Directions to “ AMIT NANAVATI MD” Practice Location

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