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Individual

PARVESH K. BANSAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1400 PINE ST, SUITE A, MELBOURNE, FL 32901-3170
(321) 676-6000
(321) 676-7000
Mailing address
1400 PINE ST, SUITE A, MELBOURNE, FL 32901-3170
(321) 676-6000
(321) 676-7000

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
ME50550
FL
207RP1001X
Pulmonary Disease Physician
Primary
ME50550
FL
207RS0012X
Sleep Medicine (Internal Medicine) Physician
ME 50550
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
03989Y
INDIVIDUAL PTAN
FL
05
046576300
FL
Enumeration date
07/07/2006
Last updated
03/07/2023
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