Provider Demographics
NPI:1477731149
Name:C U NAWADA MD PA
Entity Type:Organization
Organization Name:C U NAWADA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:C.
Authorized Official - Middle Name:U
Authorized Official - Last Name:NAWADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:863-293-2924
Mailing Address - Street 1:1121 1ST ST S
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-3902
Mailing Address - Country:US
Mailing Address - Phone:863-293-2924
Mailing Address - Fax:863-294-3450
Practice Address - Street 1:1121 1ST ST S
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-3902
Practice Address - Country:US
Practice Address - Phone:863-293-2924
Practice Address - Fax:863-294-3450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-05
Last Update Date:2008-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty