Individual
DR. PARDEEP BANSAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 W COCOA BEACH CSWY, COCOA BEACH, FL 32931-5595
(321) 434-8078
(321) 434-8075
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
C1-0028054
DE
207RG0100X
Gastroenterology Physician
Primary
MD437650
PA
207RG0100X
Gastroenterology Physician
ME164384
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023423400003
—
PA
05
—
119606200
—
FL
01
—
C1-0028054
STATE OF DELAWARE
DE
01
—
RR373
HFMG MA
FL
Enumeration date
12/13/2008
Last updated
05/07/2025
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