Healthcare Provider Details

I. General information

NPI: 1497747216
Provider Name (Legal Business Name): UDAY HIREMATH M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 N CENTRAL AVE
INVERNESS FL
34453-3838
US

IV. Provider business mailing address

PO BOX 640573
BEVERLY HILLS FL
34464-0573
US

V. Phone/Fax

Practice location:
  • Phone: 352-344-0977
  • Fax: 352-344-3414
Mailing address:
  • Phone: 352-344-0977
  • Fax: 352-344-3414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME90418
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: