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NPI Code Detail

MEDICARE: BANEY NANDLALL MD

MEDICARE: BANEY NANDLALL 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 PhysicianME94248FL

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 : 1760441117
Entity Type Code : Individual
Provider Name (Legal Business Name) : BANEY NANDLALL MD
Provider Business Mailing Address
First Line : 525 TECHNOLOGY PARK STE 109
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-7107
Country : US
Telephone Number : 407-647-2346
Fax Number : 407-647-5431
Provider Business Practice Location Address
First Line : 525 TECHNOLOGY PARK STE 109
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-7107
Country : US
Telephone Number : 407-647-2346
Fax Number : 407-647-5431
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2006
Last Update Date : 10/20/2025

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Directions to “ BANEY NANDLALL MD” Practice Location

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