Healthcare Provider Details

I. General information

NPI: 1184184533
Provider Name (Legal Business Name): SANJAY PARKER LAMSAL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 KINGSLEY AVE
ORANGE PARK FL
32073-5156
US

IV. Provider business mailing address

9745 TOUCHTON RD UNIT 124
JACKSONVILLE FL
32246-4488
US

V. Phone/Fax

Practice location:
  • Phone: 904-639-2015
  • Fax:
Mailing address:
  • Phone: 904-891-3777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberOS22634
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberOS22634
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: