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General NPI Number Information
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NPI Number | 1336913516
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Entity Type | Organization
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Legal Business Name | SIDHU HEALTH INC
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Dates
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Enumeration Date | 11/08/2023
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Last Update Date | 01/23/2024
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Provider Practice Location Address
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Address Line | 2595 TAMPA RD STE C
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City | PALM HARBOR
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State | FL
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Zip | 34684-3130
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Country | US
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Telephone | 630-849-8756
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Fax |
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Provider Business Mailing Address
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Address Line | 2595 TAMPA RD STE C
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City | PALM HARBOR
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State | FL
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Zip | 34684-3130
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KANWALJIT SIDHU
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Credential |
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Telephone | 630-849-8756
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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