Provider Demographics
NPI:1740232214
Name:GOWDA, NARENDRA KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:NARENDRA
Middle Name:KUMAR
Last Name:GOWDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:NARENDRA
Other - Middle Name:
Other - Last Name:GOWDA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5115 N PALAFOX ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32505-2932
Mailing Address - Country:US
Mailing Address - Phone:850-378-8773
Mailing Address - Fax:850-378-8778
Practice Address - Street 1:5115 N PALAFOX ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32505-2932
Practice Address - Country:US
Practice Address - Phone:850-378-8773
Practice Address - Fax:850-378-8778
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD25446207R00000X
FLME85131207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051543915OtherBCBS
AL009911303Medicaid
FL2650371-00Medicaid
FL2650371-00Medicaid
FL17358Medicare PIN
AL009911303Medicaid