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General NPI Number Information
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NPI Number | 1427279611
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Entity Type | Individual
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Provider Name | SUDHIR HANSALIA MD
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Gender | Male
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 08/31/2020
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Provider Practice Location Address
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Address Line | 3611 LITTLE RD
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City | TRINITY
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State | FL
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Zip | 34655-1813
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Country | US
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Telephone | 727-312-4300
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Fax | 727-413-4335
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Provider Business Mailing Address
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Address Line | 5000 PARK ST N STE 1017
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City | ST PETERSBURG
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State | FL
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Zip | 33709-2236
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Country | US
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Telephone | 727-344-6570
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Fax | 727-384-4388
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | ME114725
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License Number State | FL
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