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General NPI Number Information
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NPI Number | 1558321158
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Entity Type | Individual
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Provider Name | VIRESH MOHANLAL MD
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Gender | Male
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Dates
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Enumeration Date | 03/27/2006
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Last Update Date | 07/01/2016
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Provider Practice Location Address
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Address Line | 3885 OAKWATER CIR
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City | ORLANDO
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State | FL
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Zip | 32806-6257
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Country | US
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Telephone | 407-894-4693
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Fax |
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Provider Business Mailing Address
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Address Line | 3885 OAKWATER CIR SUITE C
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City | ORLANDO
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State | FL
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Zip | 32806-6257
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Country | US
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Telephone | 407-851-6226
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Fax | 407-438-0507
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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 | D0061504
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | ME109408
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License Number State | FL
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