Healthcare Provider Details

I. General information

NPI: 1336652023
Provider Name (Legal Business Name): KHUSHBU DALSANIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2017
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3632 LAND O LAKES BLVD STE 101
LAND O LAKES FL
34639-4407
US

IV. Provider business mailing address

3632 LAND O LAKES BLVD STE 101
LAND O LAKES FL
34639-4407
US

V. Phone/Fax

Practice location:
  • Phone: 813-606-5668
  • Fax:
Mailing address:
  • Phone: 813-606-5668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP9432273
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: