Provider Demographics
NPI:1487699625
Name:PAL, PARUL (MD)
Entity type:Individual
Prefix:DR
First Name:PARUL
Middle Name:
Last Name:PAL
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 1:1206 N MILLS AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-2560
Mailing Address - Country:US
Mailing Address - Phone:407-228-4035
Mailing Address - Fax:407-897-3491
Practice Address - Street 1:1206 N MILLS AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-2560
Practice Address - Country:US
Practice Address - Phone:407-228-4035
Practice Address - Fax:407-897-3491
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME80157174400000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL262775200Medicaid
FL35330AMedicare ID - Type UnspecifiedMD
FL262775200Medicaid