Healthcare Provider Details

I. General information

NPI: 1609841840
Provider Name (Legal Business Name): ARUN CHANDRAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 06/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

PO BOX 918025
ORLANDO FL
32891-8025
US

V. Phone/Fax

Practice location:
  • Phone: 386-328-0108
  • Fax: 386-325-1086
Mailing address:
  • Phone: 352-392-6431
  • Fax: 352-392-0547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME89268
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberME89268
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: