Healthcare Provider Details

I. General information

NPI: 1861540544
Provider Name (Legal Business Name): NARENDRA K MAHESHWARI MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 12/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

601 E SAMPLE RD STE 101
POMPANO BEACH FL
33064-4443
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 Code207RA0000X
TaxonomyAdolescent Medicine (Internal Medicine) Physician
License NumberME0060039
License Number StateFL

VIII. Authorized Official

Name: DR. NARENDRA K MAHESHWARI
Title or Position: MEDICAL DOCTOR
Credential: MD
Phone: 954-942-9233