Healthcare Provider Details

I. General information

NPI: 1558048330
Provider Name (Legal Business Name): FNU NAINA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2023
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date: 02/02/2024
Reactivation Date: 06/18/2024

III. Provider practice location address

301 MEMORIAL MEDICAL PKWY STE 321
DAYTONA BEACH FL
32117-5167
US

IV. Provider business mailing address

13601 BRUCE B DOWN BLVD SUITE 321
TAMPA FL
33613
US

V. Phone/Fax

Practice location:
  • Phone: 386-231-6000
  • Fax:
Mailing address:
  • Phone: 863-971-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberTRN37589
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: