PAWANARD MODPRADIT APRN NPI 1245905173

NPI Information

NPI: 1245905173
Provider Name: PAWANARD MODPRADIT, APRN
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
8925 COLONIAL CENTER DR STE 1000
FORT MYERS, FL
ZIP 33905
Phone: (239) 343-9560
Get Directions

Pawanard Modpradit, APRN is a family nurse practitioner in Fort Myers, FL with 5 years of experience. Pawanard Modpradit, APRN NPI is 1245905173. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

8925 COLONIAL CENTER DR STE 1000
FORT MYERS, FL
ZIP 33905-813
Phone: (239) 343-9560

The NPI 1245905173 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/12/2021 and was last updated on 11/10/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		APRN11005605	FLORIDA	No
2	363LF0000X	Nurse Practitioner	Family	APRN11005605	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	111431800	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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