Healthcare Provider Details

I. General information

NPI: 1306135959
Provider Name (Legal Business Name): RONICA HAZARIWALA NANDA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2011
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4501 BRUCE B DOWNS BLVD STE 205
WESLEY CHAPEL FL
33544-9216
US

IV. Provider business mailing address

2995 DREW ST FL 2
CLEARWATER FL
33759-3012
US

V. Phone/Fax

Practice location:
  • Phone: 813-914-2000
  • Fax:
Mailing address:
  • Phone: 727-532-0002
  • Fax: 813-635-2613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberME130580
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: