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NPI Code Detail

MEDICARE: DR. DIVYA PINGLE M.D.

MEDICARE: DR. DIVYA PINGLE M.D.
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 Physician036108508IL
2207R00000XInternal Medicine PhysicianME96478FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518926021
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DIVYA PINGLE M.D.
Provider Business Mailing Address
First Line : 35 DEEP WOODS WAY
Second Line :
City : ORMOND BEACH
State : FL
Zip : 32174-1848
Country : US
Telephone Number : 386-615-1457
Fax Number :
Provider Business Practice Location Address
First Line : 60 MEMORIAL MEDICAL PKWY
Second Line :
City : PALM COAST
State : FL
Zip : 32164-5980
Country : US
Telephone Number : 386-586-4743
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2006
Last Update Date : 02/12/2014

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Directions to “ DR. DIVYA PINGLE M.D.” Practice Location

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