Healthcare Provider Details

I. General information

NPI: 1942772330
Provider Name (Legal Business Name): DHANVAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2018
Last Update Date: 12/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 S ANDREWS AVE
FORT LAUDERDALE FL
33316-2510
US

IV. Provider business mailing address

10315 USA TODAY WAY
MIRAMAR FL
33025-3902
US

V. Phone/Fax

Practice location:
  • Phone: 954-355-4400
  • Fax:
Mailing address:
  • Phone: 954-474-4704
  • Fax: 954-587-8686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: SUNIL KUMAR
Title or Position: CEO
Credential: MD
Phone: 954-474-4704