Healthcare Provider Details

I. General information

NPI: 1578397147
Provider Name (Legal Business Name): FLORIDA HOME & WOUND CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2024
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6735 CONROY RD STE 231
ORLANDO FL
32835-3570
US

IV. Provider business mailing address

6735 CONROY RD STE 231
ORLANDO FL
32835-3570
US

V. Phone/Fax

Practice location:
  • Phone: 407-438-3557
  • Fax:
Mailing address:
  • Phone: 407-438-3557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SANJAY KHUBCHANDANI
Title or Position: PHYSICIAN OWNER/ MANAGER
Credential: MD
Phone: 407-438-3557