Healthcare Provider Details

I. General information

NPI: 1912563628
Provider Name (Legal Business Name): PARSHWA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2019
Last Update Date: 05/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 N JIMMIE FOXX PATH
HERNANDO FL
34442-5181
US

IV. Provider business mailing address

1670 N JIMMIE FOXX PATH
HERNANDO FL
34442-5181
US

V. Phone/Fax

Practice location:
  • Phone: 424-423-7476
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GAURAV SHAH
Title or Position: OWNER
Credential:
Phone: 423-747-6025