Provider Demographics
NPI:1629159793
Name:SINGH, VINOD (MD)
Entity Type:Individual
Prefix:DR
First Name:VINOD
Middle Name:
Last Name:SINGH
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 1:13280 CORBEL CIR APT 1925
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-7873
Mailing Address - Country:US
Mailing Address - Phone:941-592-1164
Mailing Address - Fax:
Practice Address - Street 1:1415 HOMESTEAD RD N
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-4830
Practice Address - Country:US
Practice Address - Phone:239-491-8092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME117779207RA0401X, 2084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIM319ZOtherMEDICARE PTAN
FL010053500Medicaid
NC890160WMedicaid
FLRS05KOtherBLUE CROSS
NCA88587Medicare UPIN