Provider Demographics
NPI:1073920807
Name:VERMA, NATASHA (MD)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:VERMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2102 TRINITY OAKS BLVD SUITE 216
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655
Mailing Address - Country:US
Mailing Address - Phone:727-372-2501
Mailing Address - Fax:813-635-2698
Practice Address - Street 1:2102 TRINITY OAKS BLVD SUITE 216
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655
Practice Address - Country:US
Practice Address - Phone:727-372-2501
Practice Address - Fax:813-635-2698
Is Sole Proprietor?:No
Enumeration Date:2014-07-14
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME157606207Q00000X
WI66799207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL115688900Medicaid