MEDICARE: GANESH KV NAIR 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
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	ME140328	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1710915954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GANESH KV NAIR M.D.

Provider Business Mailing Address
First Line	:	500 E CENTRAL AVE
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33880-3094
Country	:	US
Telephone Number	:	863-293-1191
Fax Number	:

Provider Business Practice Location Address
First Line	:	199 AVENUE B NW
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33881-4546
Country	:	US
Telephone Number	:	863-293-1191
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	04/29/2020

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