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General NPI Number Information
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NPI Number | 1598326316
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Entity Type | Organization
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Legal Business Name | SPECTRUM MEDICAL PARTNERS
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Dates
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Enumeration Date | 06/24/2019
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Last Update Date | 06/24/2019
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Provider Practice Location Address
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Address Line | 525 TECHNOLOGY PARK STE 109
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City | LAKE MARY
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State | FL
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Zip | 32746-7107
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Country | US
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Telephone | 407-647-2346
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Fax | 407-647-5431
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Provider Business Mailing Address
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Address Line | 525 TECHNOLOGY PARK STE 109
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City | LAKE MARY
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State | FL
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Zip | 32746-7107
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Country | US
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Telephone | 407-647-2346
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Fax | 407-647-5431
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Authorized Official
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Title or Position | CEO
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Name | DR. KRISHAN NAGDA
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Credential | MD
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Telephone | 407-647-2346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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