Provider Demographics
NPI:1558923300
Name:PAREKH, PRIYA (NP)
Entity Type:Individual
Prefix:MRS
First Name:PRIYA
Middle Name:
Last Name:PAREKH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-495-4390
Mailing Address - Fax:239-343-4083
Practice Address - Street 1:3501 HEALTH CENTER BLVD STE 2120
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:34135-8128
Practice Address - Country:US
Practice Address - Phone:239-495-4390
Practice Address - Fax:239-343-4083
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11003068363LF0000X
IN71009058A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL112278600Medicaid