Healthcare Provider Details

I. General information

NPI: 1538323399
Provider Name (Legal Business Name): DEEPINDER GOYAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3885 OAKWATER CIR
ORLANDO FL
32806-6257
US

IV. Provider business mailing address

3885 OAKWATER CIR
ORLANDO FL
32806-6257
US

V. Phone/Fax

Practice location:
  • Phone: 407-851-5600
  • Fax: 407-438-0507
Mailing address:
  • Phone: 407-851-6226
  • Fax: 407-438-0507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberQ5388
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA110628
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberA110628
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberQ5388
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA110628
License Number StateCA
# 6
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberQ5388
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: