Provider Demographics
NPI:1952033300
Name:VAIDYA, ANAGHA (PA)
Entity Type:Individual
Prefix:
First Name:ANAGHA
Middle Name:
Last Name:VAIDYA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 WEKIVA COMMONS CIR
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-3645
Mailing Address - Country:US
Mailing Address - Phone:407-464-9516
Mailing Address - Fax:407-464-9519
Practice Address - Street 1:515 WEKIVA COMMONS CIR
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-3645
Practice Address - Country:US
Practice Address - Phone:407-464-9516
Practice Address - Fax:407-464-9519
Is Sole Proprietor?:No
Enumeration Date:2022-06-24
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
363AM0700X
FLPA9115300363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical