Provider Demographics
NPI:1306814694
Name:MENEZES, NARESH P (MD)
Entity Type:Individual
Prefix:
First Name:NARESH
Middle Name:P
Last Name:MENEZES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38135 MARKET SQ
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-7505
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2100 VIA BELLA BLVD STE 204
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34639-5429
Practice Address - Country:US
Practice Address - Phone:813-751-3636
Practice Address - Fax:813-377-1678
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88566207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL43153OtherBCBS OF FL
FL269649500Medicaid
P00158129OtherRAILROAD MCR GROUP# CH7269
FLP00984623OtherRR MCR
G63599Medicare UPIN
FL269649500Medicaid