Individual
INDIA BANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2950 CLEVELAND CLINIC BLVD, WESTON, FL 33331-3609
(954) 659-5000
Mailing address
5811 TOSCANA DR APT 521, DAVIE, FL 33314-3585
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9113936
FL
363AS0400X
Surgical Physician Assistant
PA9113936
FL
Other
Enumeration date
04/11/2019
Last updated
06/28/2023
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