Provider Demographics
NPI:1306831896
Name:BEDI, JASKARAN SINGH (MD)
Entity Type:Individual
Prefix:
First Name:JASKARAN
Middle Name:SINGH
Last Name:BEDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 SE 165TH MULBERRY LN
Mailing Address - Street 2:THE VILLAGES VA OUTPATIENT CLINIC
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162
Mailing Address - Country:US
Mailing Address - Phone:352-674-5000
Mailing Address - Fax:352-674-5001
Practice Address - Street 1:8900 SE 165TH MULBERRY LN
Practice Address - Street 2:THE VILLAGES VA OUTPATIENT CLINIC
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162
Practice Address - Country:US
Practice Address - Phone:352-674-5000
Practice Address - Fax:352-674-5001
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME76295207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL256408400Medicaid
FL256408400Medicaid
FLE37052Medicare PIN