Organization
PUSHPA P NIRMUL MD PA
Active
Other names
Brandon Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PUSHPA P NIRMUL MD (PRESIDENT)
(813) 689-7571
Entity
Organization
Contact information
Practice address
602 VONDERBURG DR, SUITE 101, BRANDON, FL 33511-5900
(813) 689-7571
Mailing address
602 VONDERBURG DR, SUITE 101, BRANDON, FL 33511-5900
(813) 689-7571
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME0038457
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
066482100
—
FL
05
—
280401800
—
FL
Enumeration date
01/28/2008
Last updated
09/15/2011
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