Provider Demographics
NPI:1164968277
Name:SEEMONGAL, HARDAI R (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:HARDAI
Middle Name:R
Last Name:SEEMONGAL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 BRIARWOOD TER
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33325-6309
Mailing Address - Country:US
Mailing Address - Phone:954-296-2067
Mailing Address - Fax:
Practice Address - Street 1:710 BRIARWOOD TER
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33325-6309
Practice Address - Country:US
Practice Address - Phone:954-296-2067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-12
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 3309432363L00000X
FLAPRN3309432363LG0600X
COAPN.0993608-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology