Provider Demographics
NPI:1225003668
Name:SIDHU, HARINDER KAUR (MD)
Entity Type:Individual
Prefix:MS
First Name:HARINDER
Middle Name:KAUR
Last Name:SIDHU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 E MICHIGAN ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-5041
Mailing Address - Country:US
Mailing Address - Phone:407-897-1100
Mailing Address - Fax:407-897-1160
Practice Address - Street 1:2611 E MICHIGAN ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-5041
Practice Address - Country:US
Practice Address - Phone:407-897-1100
Practice Address - Fax:407-897-1160
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0058803204C00000X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE73844Medicare UPIN
FL11925AMedicare ID - Type UnspecifiedINDIVIDUAL
FL130014626 RRMedicare PIN