Basic Information
| Provider Information | |||||||||
| NPI: | 1114463791 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ASOK KUMAR | ||||||||
| FirstName: | BINDU | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 102222 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303682222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2392748200 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8260 GLADIOLUS DR | ||||||||
| Address2: | |||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339084156 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2394375755 | ||||||||
| FaxNumber: | 2394375776 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/06/2017 | ||||||||
| LastUpdateDate: | 09/19/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | APRN9256430 | FL | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363L00000X | APRN9256430 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | P01822937 | 01 | FL | RR MEDICARE | OTHER | P984105 | 01 | FL | OPTIMUM | OTHER | P1051947 | 01 | FL | FREEDOM | OTHER | QMP000005304168 | 01 | FL | MOLINA | OTHER | 020513800 | 05 | FL | MEDICAID | 403346 | 01 | FL | AVMED | OTHER | C4KC4 | 01 | FL | BCBS | OTHER | 3530686 | 01 | FL | CIGNA | OTHER |