Provider Demographics
NPI:1265404354
Name:PAVAN K ANAND MD PA
Entity type:Organization
Organization Name:PAVAN K ANAND MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAVAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:ANAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:239-435-1999
Mailing Address - Street 1:599 9TH ST N
Mailing Address - Street 2:STE 210
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102
Mailing Address - Country:US
Mailing Address - Phone:239-435-1999
Mailing Address - Fax:239-435-9697
Practice Address - Street 1:599 9TH ST N
Practice Address - Street 2:STE 210
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102
Practice Address - Country:US
Practice Address - Phone:239-435-1999
Practice Address - Fax:239-435-9697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-03
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0071556207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK2270Medicare PIN