Healthcare Provider Details

I. General information

NPI: 1215399886
Provider Name (Legal Business Name): AJAYPAL SINGH KANDA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2016
Last Update Date: 01/10/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 SW 1ST AVE
OCALA FL
34471-6504
US

IV. Provider business mailing address

150 SE 17TH ST STE 503
OCALA FL
34471-5176
US

V. Phone/Fax

Practice location:
  • Phone: 352-433-2825
  • Fax:
Mailing address:
  • Phone: 352-433-2825
  • Fax: 352-433-2893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number268489
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME148233
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: