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General NPI Number Information
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NPI Number | 1790861532
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Entity Type | Individual
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Provider Name | VIJAY NARASIMHA MD
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Gender | Male
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 116 PARSONS PARK DR
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City | BRANDON
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State | FL
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Zip | 33511-6066
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Country | US
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Telephone | 813-684-5255
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Fax | 813-654-7457
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Provider Business Mailing Address
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Address Line | 205 S.MOON AVE, STE 102
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City | BRANDON
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State | FL
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Zip | 33511-5716
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Country | US
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Telephone | 813-681-4644
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Fax | 813-654-4486
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME78612
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | ME0078612
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License Number State | FL
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