Basic Information
| Provider Information | |||||||||
| NPI: | 1013485655 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PALLAVI ANEJA MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2410 NORTHSIDE DR | ||||||||
| Address2: | |||||||||
| City: | CLEARWATER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337612236 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7274990351 | ||||||||
| FaxNumber: | 7277812300 | ||||||||
| Practice Location | |||||||||
| Address1: | 201 NW 82ND AVE STE 105 | ||||||||
| Address2: | |||||||||
| City: | PLANTATION | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333241853 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3124023358 | ||||||||
| FaxNumber: | 7277813200 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/12/2018 | ||||||||
| LastUpdateDate: | 11/12/2018 | ||||||||
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| AuthorizedOfficialLastName: | ANEJA | ||||||||
| AuthorizedOfficialFirstName: | PALLAVI | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3124023358 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.