Provider Demographics
NPI: | 1215081252 |
---|---|
Name: | SEERAM, VANDANA (MD) |
Entity type: | Individual |
Prefix: | |
First Name: | VANDANA |
Middle Name: | |
Last Name: | SEERAM |
Suffix: | |
Gender: | F |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 653 W 8TH ST # L18 |
Mailing Address - Street 2: | LRC, 4TH FLOOR |
Mailing Address - City: | JACKSONVILLE |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 32209-6511 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 904-244-3086 |
Mailing Address - Fax: | 904-244-3634 |
Practice Address - Street 1: | 653 W 8TH ST # L18 |
Practice Address - Street 2: | LRC, 4TH FLOOR |
Practice Address - City: | JACKSONVILLE |
Practice Address - State: | FL |
Practice Address - Zip Code: | 32209-6511 |
Practice Address - Country: | US |
Practice Address - Phone: | 904-244-3086 |
Practice Address - Fax: | 904-244-3634 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2007-01-23 |
Last Update Date: | 2022-09-01 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | TRN10728 | 207R00000X |
FL | ME114459 | 207RP1001X, 207RC0200X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207RC0200X | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | |
No | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |