Provider Demographics
NPI:1932246873
Name:POHANI, NEETA S (MD)
Entity type:Individual
Prefix:DR
First Name:NEETA
Middle Name:S
Last Name:POHANI
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 1:19913 W NEWBERRY RD STE A
Mailing Address - Street 2:PO BOX 1287
Mailing Address - City:NEWBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32669-2181
Mailing Address - Country:US
Mailing Address - Phone:352-472-5775
Mailing Address - Fax:352-472-5761
Practice Address - Street 1:19913 W NEWBERRY RD STE A
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:FL
Practice Address - Zip Code:32669-2181
Practice Address - Country:US
Practice Address - Phone:352-472-5775
Practice Address - Fax:352-472-5761
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME80856207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL264986100Medicaid
FLG13939Medicare UPIN
FL58907Medicare ID - Type UnspecifiedMEDICARE NUMBER