Provider Demographics
NPI:1023059730
Name:MOHAN, VINEETH (MD)
Entity type:Individual
Prefix:
First Name:VINEETH
Middle Name:
Last Name:MOHAN
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 1:350 CAMINO GARDENS BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-5825
Mailing Address - Country:US
Mailing Address - Phone:561-710-6525
Mailing Address - Fax:561-462-0839
Practice Address - Street 1:350 CAMINO GARDENS BLVD STE 202
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-5825
Practice Address - Country:US
Practice Address - Phone:561-710-6525
Practice Address - Fax:561-462-0839
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95884207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism