Individual
DR. BADRI NATH MEHROTRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D. P.A.
Contact information
Practice address
301 HEALTH PARK BLVD, SUITE 216, ST. AUGUSTINE, FL 32086
(904) 824-9044
(904) 824-9055
Mailing address
301 HEALTH PARK BLVD, SUITE 216, ST. AUGUSTINE, FL 32086
(904) 824-9044
(904) 824-9055
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
ME0021344
FL
207RG0100X
Gastroenterology Physician
Primary
ME0021344
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
052939700
—
FL
01
—
494005
AETNA-SPECIALTY
FL
Enumeration date
07/11/2006
Last updated
10/27/2010
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