Provider Demographics
NPI:1780692111
Name:NARENDRA K. MAHESHWARI, MD, PA
Entity type:Organization
Organization Name:NARENDRA K. MAHESHWARI, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NARENDRA
Authorized Official - Middle Name:K
Authorized Official - Last Name:MAHESHWARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-942-9233
Mailing Address - Street 1:2323 NE 26TH AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-1147
Mailing Address - Country:US
Mailing Address - Phone:954-942-9233
Mailing Address - Fax:954-942-9234
Practice Address - Street 1:2323 NE 26TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-1147
Practice Address - Country:US
Practice Address - Phone:954-942-9233
Practice Address - Fax:954-942-9234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL971360100Medicaid
FL15088Medicare ID - Type Unspecified