Provider Demographics
NPI:1467662205
Name:NARULA, JAGDEEP SINGH (MD)
Entity Type:Individual
Prefix:
First Name:JAGDEEP
Middle Name:SINGH
Last Name:NARULA
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 1:8551 NW 7TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6635
Mailing Address - Country:US
Mailing Address - Phone:954-704-9300
Mailing Address - Fax:
Practice Address - Street 1:8992 TAFT ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-4668
Practice Address - Country:US
Practice Address - Phone:954-704-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0069947207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251083900Medicaid
FL32099OtherBLUE CROSS & BLUE SHIELD
FLG37960Medicare UPIN