Healthcare Provider Details

I. General information

NPI: 1710972203
Provider Name (Legal Business Name): NITIN ANAND DHAON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 LAKELAND HIGHLANDS RD
LAKELAND FL
33812-4507
US

IV. Provider business mailing address

4000 LAKELAND HIGHLANDS RD
LAKELAND FL
33812-4507
US

V. Phone/Fax

Practice location:
  • Phone: 868-680-7000
  • Fax: 863-904-2630
Mailing address:
  • Phone: 868-680-7000
  • Fax: 863-904-2630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME0086492
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberME86492
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME86492
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberME86492
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: