Healthcare Provider Details

I. General information

NPI: 1184382996
Provider Name (Legal Business Name): NARAYANA HEALTHCARE ALLIANCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2021
Last Update Date: 05/28/2024
Certification Date: 05/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 S HARBOR CITY BLVD STE A
MELBOURNE FL
32901-1500
US

IV. Provider business mailing address

308 S HARBOR CITY BLVD STE A
MELBOURNE FL
32901-1500
US

V. Phone/Fax

Practice location:
  • Phone: 321-254-9060
  • Fax:
Mailing address:
  • Phone: 321-254-9060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. PARAMJIT S AHLUWALIA
Title or Position: SOLE MBR
Credential:
Phone: 321-254-9060