Provider Demographics
NPI:1366501298
Name:NANDE, NORMA A (PHY)
Entity Type:Individual
Prefix:MS
First Name:NORMA
Middle Name:A
Last Name:NANDE
Suffix:
Gender:F
Credentials:PHY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13410 SW 18 STREET
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175
Mailing Address - Country:US
Mailing Address - Phone:305-221-0726
Mailing Address - Fax:305-553-8889
Practice Address - Street 1:12800 SW 8 STREET
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184
Practice Address - Country:US
Practice Address - Phone:305-221-0101
Practice Address - Fax:305-553-8889
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS18010183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS18010OtherSTATE LICENSE