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General NPI Number Information
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NPI Number | 1164667879
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Entity Type | Organization
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Legal Business Name | HARE KRISHNA MEDICAL CARE PA
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Dates
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Enumeration Date | 12/09/2008
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Last Update Date | 06/25/2009
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Provider Practice Location Address
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Address Line | 1524 SE 3RD AVE
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City | FORT LAUDERDALE
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State | FL
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Zip | 33316-2502
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Country | US
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Telephone | 954-763-6188
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Fax | 954-763-6199
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Provider Business Mailing Address
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Address Line | 5347 SW 34TH TER
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City | FORT LAUDERDALE
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State | FL
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Zip | 33312-5552
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Country | US
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Telephone | 954-763-6188
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Fax | 954-763-6199
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KISHOR O SHETH
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Credential | M.D.
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Telephone | 19173732774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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