Pantangi, Vivekanand
Pantangi, Vivekanand is an sole proprietor health care provider with primary practice located at 305 Memorial Medical Pkwy Ste 502 , Daytona Beach FL 32117-5169. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Pantangi, Vivekanand can be contacted via phone (386) 231-3570.Contact Information
Primary practice address
305 Memorial Medical Pkwy Ste 502
Daytona Beach FL 32117-5169
Phone: (386) 231-3570
Fax: (386) 231-3571
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD172397 | Oregon |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | MD172397 | Oregon |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ME166124 | Florida |
Profile Details
| NPI number | 1508123183 |
|---|---|
| LBN Legal business name | Pantangi, Vivekanand |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 19th, 2012 |
| Last updated | Apr 23rd, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508123183 | NPPES |
| Oregon | MEDICAID | 500689975 |
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