Provider Demographics
NPI:1568586907
Name:PARIKH, HANSA M (MD)
Entity Type:Individual
Prefix:DR
First Name:HANSA
Middle Name:M
Last Name:PARIKH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:598 STERTHAUS AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-5128
Mailing Address - Country:US
Mailing Address - Phone:386-672-9683
Mailing Address - Fax:386-677-3808
Practice Address - Street 1:598 STERTHAUS AVE
Practice Address - Street 2:SUITE C
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-5128
Practice Address - Country:US
Practice Address - Phone:386-672-9683
Practice Address - Fax:386-677-3808
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME29090174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
K2029Medicare ID - Type Unspecified
FLD86178Medicare UPIN