Individual
SIDDHARTH ARUN WAYANGANKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
836 PRUDENTIAL DR STE 1700, JACKSONVILLE, FL 32207-8344
(904) 398-0125
(904) 398-1832
Mailing address
PO BOX 746652, ATLANTA, GA 30374-6652
(904) 720-0599
(904) 376-4036
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
26349
OK
207RC0000X
Cardiovascular Disease Physician
ME128031
FL
207RI0011X
Interventional Cardiology Physician
Primary
ME128031
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017815100
—
FL
Enumeration date
06/11/2008
Last updated
07/30/2024
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