Most Relevant Information
Provider Data
| NPI Number: | 1003059270 |
| Provider Name: | NASRIN DATAR RAINA M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 207Q00000X |
| Specialty: | Family Medicine |
| License Number: | ME139724 |
Most Important Dates
| Enumeration Date: | 04/16/2009 |
| Last Updated: | 06/15/2020 |
Provider Practice Location
151 PINE LAKE DR STE B
PONTE VEDRA
FL
320815136
Practice Location Phone/Fax
| Phone: | 9045433677 |
| Fax: |
Provider Mailing Location
151 PINE LAKE DR STE B
PONTE VEDRA
FL
320815136
Provider Mailing Phone/Fax
| Phone: | 9045433677 |
| Fax: | 9045872586 |
Suggested EMR
Family Practice EMR