Healthcare Provider Details

I. General information

NPI: 1588617039
Provider Name (Legal Business Name): NARENDRA K MAHESHWARI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 04/05/2022
Certification Date: 04/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E SAMPLE RD SUITE 101
POMPANO BEACH FL
33064-4443
US

IV. Provider business mailing address

601 EAST SAMPLE ROAD 101
DEERFIELD BEACH FL
33064
US

V. Phone/Fax

Practice location:
  • Phone: 954-942-9233
  • Fax: 954-942-9234
Mailing address:
  • Phone: 954-942-9233
  • Fax: 954-942-9234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME0060039
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: