Healthcare Provider Details

I. General information

NPI: 1639121643
Provider Name (Legal Business Name): SANDHYA NEMADE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6405 N FEDERAL HWY STE 300
FORT LAUDERDALE FL
33308-1414
US

IV. Provider business mailing address

1700 NW 49TH ST STE 125
FORT LAUDERDALE FL
33309-3750
US

V. Phone/Fax

Practice location:
  • Phone: 954-771-7294
  • Fax: 954-776-8956
Mailing address:
  • Phone: 954-771-7294
  • Fax: 954-776-8956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberME64571
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME64571
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: