Healthcare Provider Details

I. General information

NPI: 1073200630
Provider Name (Legal Business Name): AKSHAY N NARENDRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2023
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 1ST ST N
WINTER HAVEN FL
33881-4111
US

IV. Provider business mailing address

325 1ST ST N
WINTER HAVEN FL
33881-4111
US

V. Phone/Fax

Practice location:
  • Phone: 863-293-1191
  • Fax:
Mailing address:
  • Phone: 863-293-1191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME179595
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberTL.0009872
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: