Healthcare Provider Details

I. General information

NPI: 1699843599
Provider Name (Legal Business Name): GOWANI MEDICAL ASSOCIATES MDPLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 03/11/2020
Certification Date: 03/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7224 STONEROCK CIR
ORLANDO FL
32819-8000
US

IV. Provider business mailing address

7224 STONEROCK CIR
ORLANDO FL
32819-8000
US

V. Phone/Fax

Practice location:
  • Phone: 407-345-4999
  • Fax: 407-352-6450
Mailing address:
  • Phone: 407-345-4999
  • Fax: 407-352-6450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. YASMEEN GOWANI
Title or Position: PRESIDENT
Credential: MD
Phone: 407-345-4999