Shivanand Vijay Persad, PA-C
Family Medicine, Adult Medicine in Boca Raton, FL. Individual provider (NPI-1).
NPI number1306337753
StatusActive
Last updated in NPPESAug 9, 2022
Details
- NPI
- 1306337753
- Entity type
- Individual (NPI-1)
- Name
- Shivanand Vijay Persad
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 22, 2018
- Certification date
- Aug 9, 2022
- Last updated
- Aug 9, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207QA0505X | Family Medicine, Adult Medicine | ME135224 | FL | Yes |
Practice location
7050 W Palmetto Park Rd Ste 30Boca Raton, FL 33433-3463
Phone 954-425-9154 · Fax 866-981-1882
Mailing address
7050 W Palmetto Park Rd Ste 30Boca Raton, FL 33433-3463
Phone 954-425-9154 · Fax 866-981-1882
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