Healthcare Provider Details

I. General information

NPI: 1275692584
Provider Name (Legal Business Name): NAUSHIRA PANDYA M.D.,CMD, FACP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NAUSHIRA PANDYA

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 S UNIVERSITY DR ASSEMBLY BLDG 2, SUITE 202
DAVIE FL
33328-2018
US

IV. Provider business mailing address

3200 S UNIVERSITY DR
DAVIE FL
33328-2018
US

V. Phone/Fax

Practice location:
  • Phone: 954-262-4343
  • Fax: 954-262-1172
Mailing address:
  • Phone: 954-262-4343
  • Fax: 954-262-1172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberME88331
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: