Provider Demographics
NPI:1114463791
Name:ASOK KUMAR, BINDU (APRN)
Entity Type:Individual
Prefix:
First Name:BINDU
Middle Name:
Last Name:ASOK KUMAR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 102222
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2222
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:
Practice Address - Street 1:8260 GLADIOLUS DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-4156
Practice Address - Country:US
Practice Address - Phone:239-437-5755
Practice Address - Fax:239-437-5776
Is Sole Proprietor?:No
Enumeration Date:2017-01-06
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9256430363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01822937OtherRR MEDICARE
FLP984105OtherOPTIMUM
FLP1051947OtherFREEDOM
FLQMP000005304168OtherMOLINA
FL020513800Medicaid
FL403346OtherAVMED
FLC4KC4OtherBCBS
FL3530686OtherCIGNA
FLIX257ZMedicare PIN