=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235441544
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NIDHI KARAVADIA M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/02/2010
-----------------------------------------------------
Last Update Date | 03/10/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8550 SW HIGHWAY 200
-----------------------------------------------------
City | OCALA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34481-9653
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-854-9110
-----------------------------------------------------
Fax | 352-854-9119
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8620 SE 17TH CT
-----------------------------------------------------
City | OCALA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34480-9351
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-264-0467
-----------------------------------------------------
Fax | 352-854-9119
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | ME118382
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------