Healthcare Provider Details

I. General information

NPI: 1285677567
Provider Name (Legal Business Name): ROHIT DANDIYA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 01/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3345 BURNS RD SUITE 302
PALM BEACH GARDENS FL
33410-4324
US

IV. Provider business mailing address

3345 BURNS RD SUITE 302
PALM BEACH GARDENS FL
33410-4324
US

V. Phone/Fax

Practice location:
  • Phone: 561-622-7661
  • Fax: 561-622-4651
Mailing address:
  • Phone: 561-622-7661
  • Fax: 561-622-4651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number48128
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME0048128
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: