Healthcare Provider Details

I. General information

NPI: 1700846565
Provider Name (Legal Business Name): NEEL GOBINDRAM KARNANI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 09/22/2021
Certification Date: 09/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7406 FULLERTON ST STE 105
JACKSONVILLE FL
32256-3588
US

IV. Provider business mailing address

4320 DEERWOOD LAKE PKWY STE 101
JACKSONVILLE FL
32216-1180
US

V. Phone/Fax

Practice location:
  • Phone: 877-868-4827
  • Fax:
Mailing address:
  • Phone: 877-868-4827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberME45657
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: