Provider Demographics
NPI:1164443255
Name:SHAMAL D NADKARNI MD PA
Entity Type:Organization
Organization Name:SHAMAL D NADKARNI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHAMAL
Authorized Official - Middle Name:D
Authorized Official - Last Name:NADKARNI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-271-3200
Mailing Address - Street 1:1050 NW 8TH AVE STE 30
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-4998
Mailing Address - Country:US
Mailing Address - Phone:352-271-3200
Mailing Address - Fax:352-271-3900
Practice Address - Street 1:1026 SW 2ND AVE
Practice Address - Street 2:SUITE D
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-6134
Practice Address - Country:US
Practice Address - Phone:352-271-3200
Practice Address - Fax:352-271-3900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care