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General NPI Number Information
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NPI Number | 1508130527
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Entity Type | Organization
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Legal Business Name | FPG SPECIALISTS CARE, LLC
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Dates
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Enumeration Date | 03/08/2012
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Last Update Date | 06/19/2012
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Provider Practice Location Address
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Address Line | 6416 OLD WINTER GARDEN RD
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City | ORLANDO
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State | FL
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Zip | 32835-1348
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Country | US
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Telephone | 407-253-3535
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Fax |
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Provider Business Mailing Address
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Address Line | 6416 OLD WINTER GARDEN RD
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City | ORLANDO
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State | FL
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Zip | 32835-1348
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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 | MEDICAL DOCTOR
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Name | ANJALI I. VYAS
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Credential |
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Telephone | 407-253-3535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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