Organization
GULF COAST INFECTIOUS DISEASES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PARDEEP KUMARI MD (PRESIDENT)
(850) 549-4755
Entity
Organization
Contact information
Practice address
2120 E JOHNSON AVE, PENSACOLA, FL 32514
(850) 549-4755
(850) 549-4760
Mailing address
PO BOX 11640, PENSACOLA, FL 32524
(850) 549-4755
(850) 549-4760
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529928850
—
AL
01
—
611374600
DEPT OF LABOR
FL
Enumeration date
05/10/2006
Last updated
07/05/2020
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