Provider Demographics
NPI:1386838738
Name:PANARA MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:PANARA MEDICAL GROUP, INC.
Other - Org Name:VRAJ PANARA M.D., P.A.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VRAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:PANARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-252-7486
Mailing Address - Street 1:1907 BELFORD CT
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4210
Mailing Address - Country:US
Mailing Address - Phone:407-252-7486
Mailing Address - Fax:
Practice Address - Street 1:1907 BELFORD CT
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4210
Practice Address - Country:US
Practice Address - Phone:407-252-7486
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0061625207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL253147000Medicaid
FL253147000Medicaid
FLF28640Medicare UPIN