Provider Demographics
NPI:1053324038
Name:KANDRU, VEERENDRA N (MD)
Entity Type:Individual
Prefix:
First Name:VEERENDRA
Middle Name:N
Last Name:KANDRU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2880 NW 68TH AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34482-3952
Mailing Address - Country:US
Mailing Address - Phone:352-209-1655
Mailing Address - Fax:
Practice Address - Street 1:9920 SW 84TH CT
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481-9118
Practice Address - Country:US
Practice Address - Phone:352-873-1100
Practice Address - Fax:352-873-9151
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98160207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAG154Medicare UPIN