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General NPI Number Information
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NPI Number | 1811180870
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Entity Type | Organization
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Legal Business Name | NANDINI KIRI MD PA
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Dates
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Enumeration Date | 08/23/2007
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Last Update Date | 12/07/2011
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Provider Practice Location Address
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Address Line | 3390 TAMIAMI TRL SUITE 101
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-8157
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Country | US
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Telephone | 941-883-5454
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Fax | 941-883-5457
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Provider Business Mailing Address
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Address Line | PO BOX 495237
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City | PORT CHARLOTTE
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State | FL
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Zip | 33949-5237
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Country | US
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Telephone | 941-883-5454
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Fax | 941-883-5457
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. NANDINI KIRI
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Credential | MD PA
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Telephone | 941-883-5454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | ME82594
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License Number State | FL
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