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General NPI Number Information
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NPI Number | 1003023581
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Entity Type | Individual
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Provider Name | JAIDEEP HINGORANI
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Gender | Male
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 11/18/2009
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Provider Practice Location Address
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Address Line | 3300 TAMIAMI TRL #101A
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-8054
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Country | US
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Telephone | 941-629-4676
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Fax | 941-629-1522
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Provider Business Mailing Address
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Address Line | 3300 TAMIAMI TRL #101A
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-8054
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Country | US
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Telephone | 941-629-4676
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Fax | 941-629-1522
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | P 18943
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | ME104667
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License Number State | FL
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