Healthcare Provider Details

I. General information

NPI: 1710818752
Provider Name (Legal Business Name): PRACHI GANDHI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 BRUCE B DOWNS BLVD
WESLEY CHAPEL FL
33544-9207
US

IV. Provider business mailing address

11229 SYCAMORE GLEN LOOP
THONOTOSASSA FL
33592-3426
US

V. Phone/Fax

Practice location:
  • Phone: 813-929-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberUO11394
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: