Provider Demographics
NPI:1710987946
Name:JAMNADAS, PRADIP K (MD)
Entity Type:Individual
Prefix:
First Name:PRADIP
Middle Name:K
Last Name:JAMNADAS
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 1:1900 N MILLS AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-1444
Mailing Address - Country:US
Mailing Address - Phone:407-894-4880
Mailing Address - Fax:407-894-2364
Practice Address - Street 1:1900 N MILLS AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1444
Practice Address - Country:US
Practice Address - Phone:407-894-4880
Practice Address - Fax:407-894-2364
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-29
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 0054920207RI0011X
FLME 54920207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265836400Medicaid
FL08273ZMedicare PIN
FL265836400Medicaid