MEDICARE: PIRANI HOLDING COMPANY, PLLC

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	261QR0400X	Rehabilitation Clinic/Center	12058	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	:	1861866766
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIRANI HOLDING COMPANY, PLLC

Provider Business Mailing Address
First Line	:	6817 SOUTHPOINT PKWY STE 1602
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-6298
Country	:	US
Telephone Number	:	904-945-7556
Fax Number	:	904-379-0113

Provider Business Practice Location Address
First Line	:	6817 SOUTHPOINT PKWY STE 1602
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-6298
Country	:	US
Telephone Number	:	904-945-7556
Fax Number	:	904-379-0113

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	DR. DIVYA MAJMUDAR PIRANI
Credential	:	PT, DPT, PCS
Telephone Number	:	919-247-2450

Provider Enumeration Date	:	11/17/2015
Last Update Date	:	07/07/2020

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Directions to “PIRANI HOLDING COMPANY, PLLC ” Practice Location

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