Healthcare Provider Details

I. General information

NPI: 1881911717
Provider Name (Legal Business Name): AMIT K TANDON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2010
Last Update Date: 03/18/2024
Certification Date: 03/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 HEALING WAY STE 112
WESLEY CHAPEL FL
33543-5453
US

IV. Provider business mailing address

13067 N TELECOM PKWY
TEMPLE TERRACE FL
33637-0926
US

V. Phone/Fax

Practice location:
  • Phone: 813-929-5226
  • Fax: 813-929-5332
Mailing address:
  • Phone: 813-779-6303
  • Fax: 786-868-0012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberME136435
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME136435
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: