MEDICARE: DR. YOUSUF KHAN GANDAPUR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	D81297	MD
2	207RC0000X	Cardiovascular Disease Physician	311536	NY
3	390200000X	Student in an Organized Health Care Education/Training Program
4	207RI0011X	Interventional Cardiology Physician	ME169735	FL

General Provider Information

NPI Number	:	1790126753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YOUSUF KHAN GANDAPUR MD

Provider Business Mailing Address
First Line	:	1447 MEDICAL PARK BLVD STE 101
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33414-3164
Country	:	US
Telephone Number	:	561-753-0001
Fax Number	:	561-753-0005

Provider Business Practice Location Address
First Line	:	4631 N CONGRESS AVE STE 202
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-3234
Country	:	US
Telephone Number	:	561-753-0001
Fax Number	:	561-753-0005

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2013
Last Update Date	:	01/02/2026

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