Provider Demographics
NPI:1437341187
Name:ANAND, PAVAN K (MD)
Entity Type:Individual
Prefix:
First Name:PAVAN
Middle Name:K
Last Name:ANAND
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 1:599 9TH ST N
Mailing Address - Street 2:SUITE 210
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5623
Mailing Address - Country:US
Mailing Address - Phone:239-435-1999
Mailing Address - Fax:239-435-9697
Practice Address - Street 1:599 9TH ST N
Practice Address - Street 2:SUITE 210
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5623
Practice Address - Country:US
Practice Address - Phone:239-435-1999
Practice Address - Fax:239-435-9697
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-16
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0071556207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL32380XMedicare PIN
G36071Medicare UPIN