Organization
MEDICARE PROVIDERS NETWORK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASVENDAR SINGH NANDRA M.D. (CEO)
(407) 921-2074
Entity
Organization
Contact information
Practice address
2840 N HIAWASSEE RD, STE # 428, ORLANDO, FL 32818-3319
(407) 921-2074
(407) 264-8686
Mailing address
PO BOX 951659, LAKE MARY, FL 32795-1659
(407) 921-2074
(407) 264-8686
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
ME85696
FL
Other
Enumeration date
06/20/2013
Last updated
06/20/2013
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