Healthcare Provider Details

I. General information

NPI: 1952930851
Provider Name (Legal Business Name): DIVYA A PANDYA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2020
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 W COLONIAL DR STE 381
OCOEE FL
34761-3435
US

IV. Provider business mailing address

10000 W COLONIAL DR STE 381
OCOEE FL
34761-3435
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-3467
  • Fax: 407-253-2563
Mailing address:
  • Phone: 321-841-3467
  • Fax: 407-253-2563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number21350
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number21350
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: