Jeffrey U Banga

Individual provider Active NPI Physician Assistant · Margate, FL

NPI 1366087124 · NPPES record last updated Nov 15, 2019

Key facts

NPI
1366087124
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
Practice address
3390 Banks Rd Apt 109
Margate, FL 33063-6952
Phone
(903) 985-5550
NPI assigned
Nov 15, 2019
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 1, 2023 through Jul 1, 2027

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Yes

Addresses

Primary practice location

3390 Banks Rd Apt 109
Margate, FL 33063-6952

Mailing address

3390 Banks Rd Apt 109
Margate, FL 33063-6952
Phone (903) 985-5550

Other providers in Margate, FL

All providers in Margate, FL · Physician Assistant in Florida

Sources for this page

Verify at the official NPI Registry.