Provider Demographics
NPI:1366466476
Name:ARORA, PRADEEP (MD)
Entity Type:Individual
Prefix:DR
First Name:PRADEEP
Middle Name:
Last Name:ARORA
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 1:3636 UNIVERSITY BLVD S STE B2
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-4223
Mailing Address - Country:US
Mailing Address - Phone:844-808-9096
Mailing Address - Fax:904-638-8752
Practice Address - Street 1:3636 UNIVERSITY BLVD S STE B2
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-4223
Practice Address - Country:US
Practice Address - Phone:844-808-9096
Practice Address - Fax:904-638-8752
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME801862084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
17113OtherBCBS
FL260739501Medicaid
FL17113OtherBCBS-FL
17113OtherBCBS
G97991Medicare UPIN
FL260739501Medicaid
E6512ZMedicare ID - Type Unspecified