Provider Demographics
NPI:1922082130
Name:PANARA, NED JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:NED
Middle Name:JOHN
Last Name:PANARA
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 1:3830 S FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-1105
Mailing Address - Country:US
Mailing Address - Phone:863-519-0902
Mailing Address - Fax:863-519-0904
Practice Address - Street 1:3830 S FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-1105
Practice Address - Country:US
Practice Address - Phone:863-519-9020
Practice Address - Fax:863-519-0904
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-01
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.129742207RG0100X
WI67241207RG0100X
FLME70375207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL254132700Medicaid
E85056Medicare UPIN