Provider Demographics
NPI:1477505626
Name:PANARA, VRAJ (MD)
Entity Type:Individual
Prefix:DR
First Name:VRAJ
Middle Name:
Last Name:PANARA
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 1:1907 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:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0061625207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110183671OtherMEDICARE RAILROAD
FL370333900Medicaid
FL370333900Medicaid
FL110183671OtherMEDICARE RAILROAD