Provider Demographics
NPI:1881657732
Name:KOHLI, NAGESH (MD)
Entity Type:Individual
Prefix:DR
First Name:NAGESH
Middle Name:
Last Name:KOHLI
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 1:1834 SW 1ST AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-8101
Mailing Address - Country:US
Mailing Address - Phone:352-732-5552
Mailing Address - Fax:352-732-1131
Practice Address - Street 1:1834 SW 1ST AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-8101
Practice Address - Country:US
Practice Address - Phone:352-732-5552
Practice Address - Fax:352-732-1131
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL57687207RP1001X
FLME57687207RC0200X, 207RS0012X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL063675400Medicaid
FLF01840Medicare UPIN
FL10543ZMedicare PIN