Provider Demographics
NPI:1316257355
Name:GEETA NARULA, MD PA
Entity type:Organization
Organization Name:GEETA NARULA, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEETA
Authorized Official - Middle Name:
Authorized Official - Last Name:NARULA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-898-2924
Mailing Address - Street 1:2501 N ORANGE AVE
Mailing Address - Street 2:SUITE 505
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4603
Mailing Address - Country:US
Mailing Address - Phone:407-898-2924
Mailing Address - Fax:407-894-5387
Practice Address - Street 1:2501 N ORANGE AVE
Practice Address - Street 2:SUITE 505
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4603
Practice Address - Country:US
Practice Address - Phone:407-898-2924
Practice Address - Fax:407-894-5387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME31866208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL037079700Medicaid
FLD55532Medicare UPIN