Provider Demographics
NPI:1952452245
Name:DR. UPA CARDIOLOGY, INC
Entity Type:Organization
Organization Name:DR. UPA CARDIOLOGY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NARENDRA
Authorized Official - Middle Name:R
Authorized Official - Last Name:UPADHYAYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-986-1232
Mailing Address - Street 1:2301 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-3617
Mailing Address - Country:US
Mailing Address - Phone:954-986-1232
Mailing Address - Fax:954-986-1833
Practice Address - Street 1:2301 N UNIVERSITY DR
Practice Address - Street 2:SUITE 106
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-3617
Practice Address - Country:US
Practice Address - Phone:954-986-1232
Practice Address - Fax:954-986-1833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME60989207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
38811OtherBCBS
FL258465400Medicaid
38811OtherBCBS