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Organization
VIJAY GANATRA, M.D., P.A.
Active
Organization
VIJAY GANATRA, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIJAY D GANATRA M.D. (PRESIDENT)
(239) 561-6263
Entity
Organization
Contact information
Practice address
13770 PLANTATION RD, UNIT 4, FORT MYERS, FL 33912-4460
(239) 561-6263
(239) 561-6264
Mailing address
13770 PLANTATION RD STE 4, FORT MYERS, FL 33912-4460
(239) 561-6263
(239) 561-6264
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME84201
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
263735900
—
FL
01
—
DQ5776
RAILROAD
FL
Enumeration date
04/10/2007
Last updated
06/04/2018
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