Healthcare Provider Details

I. General information

NPI: 1659328995
Provider Name (Legal Business Name): JOSEF GEORGE THUNDIYIL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 COOK AVE
ORLANDO FL
32806-2912
US

IV. Provider business mailing address

1720 COOK AVE
ORLANDO FL
32806-2912
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-2605
  • Fax:
Mailing address:
  • Phone: 415-336-8324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA78330
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207PT0002X
TaxonomyMedical Toxicology (Emergency Medicine) Physician
License NumberME81687
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: