Provider Demographics
NPI:1003023581
Name:HINGORANI, JAIDEEP
Entity Type:Individual
Prefix:
First Name:JAIDEEP
Middle Name:
Last Name:HINGORANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 TAMIAMI TRL
Mailing Address - Street 2:#101A
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-8054
Mailing Address - Country:US
Mailing Address - Phone:941-629-4676
Mailing Address - Fax:941-629-1522
Practice Address - Street 1:3300 TAMIAMI TRL
Practice Address - Street 2:#101A
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-8054
Practice Address - Country:US
Practice Address - Phone:941-629-4676
Practice Address - Fax:941-629-1522
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP 18943207R00000X
FLME104667207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine