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General NPI Number Information
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NPI Number | 1033182027
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Entity Type | Individual
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Provider Name | KRISHAN NAGDA M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/09/2006
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Last Update Date | 12/07/2016
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Provider Practice Location Address
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Address Line | 1950 LEE RD SUITE 105
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City | WINTER PARK
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State | FL
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Zip | 32789-1859
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Country | US
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Telephone | 407-647-2346
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Fax | 407-647-5431
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Provider Business Mailing Address
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Address Line | 917 RINEHART RD STE 1051
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City | LAKE MARY
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State | FL
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Zip | 32746-4853
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Country | US
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Telephone | 407-647-2346
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Fax | 407-647-2346
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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 | ME80505
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License Number State | FL
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