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NPI Code Detail

MEDICARE: DR. NIBHA MEDIRATTA MD

MEDICARE: DR. NIBHA MEDIRATTA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianME95217FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275584369
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NIBHA MEDIRATTA MD
Provider Business Mailing Address
First Line : PO BOX 991
Second Line :
City : GOTHA
State : FL
Zip : 34734-0985
Country : US
Telephone Number : 352-243-1101
Fax Number : 352-243-1134
Provider Business Practice Location Address
First Line : 1970 HOSPITAL VIEW WAY
Second Line : UNIT 1
City : CLERMONT
State : FL
Zip : 34711-1926
Country : US
Telephone Number : 352-243-1101
Fax Number : 352-243-1134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2006
Last Update Date : 03/18/2020

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