Provider Demographics
NPI:1689031551
Name:POONAI, MAHENDRA (ARNP)
Entity Type:Individual
Prefix:
First Name:MAHENDRA
Middle Name:
Last Name:POONAI
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 HERONS RUN DR
Mailing Address - Street 2:APT 619
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-1758
Mailing Address - Country:US
Mailing Address - Phone:941-284-3506
Mailing Address - Fax:
Practice Address - Street 1:3100 S TAMIAMI TRL STE B
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-5139
Practice Address - Country:US
Practice Address - Phone:941-917-8185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-24
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9308899363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily