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General NPI Number Information
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NPI Number | 1104832062
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Entity Type | Individual
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Provider Name | SANGITA MOHAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1621 W 1ST ST
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City | SANFORD
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State | FL
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Zip | 32771-1617
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Country | US
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Telephone | 407-322-4431
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Fax | 407-322-4448
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Provider Business Mailing Address
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Address Line | PO BOX 848
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City | SANFORD
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State | FL
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Zip | 32772-0848
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Country | US
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Telephone | 407-322-4431
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Fax | 407-322-4448
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME93525
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License Number State | FL
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