Provider Demographics
NPI:1144526708
Name:AMNATH KIRDNUAL, M.D., P.A.
Entity type:Organization
Organization Name:AMNATH KIRDNUAL, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AMNATH
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRDNUAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-824-2508
Mailing Address - Street 1:201 HEALTH PARK BLVD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-5796
Mailing Address - Country:US
Mailing Address - Phone:904-824-2508
Mailing Address - Fax:904-824-3566
Practice Address - Street 1:201 HEALTH PARK BLVD
Practice Address - Street 2:SUITE 211
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-5796
Practice Address - Country:US
Practice Address - Phone:904-824-2508
Practice Address - Fax:904-824-3566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-31
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty