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General NPI Number Information
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NPI Number | 1518264134
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Entity Type | Individual
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Provider Name | NAZ GANDIKAL D.O.
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Gender | Female
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Dates
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Enumeration Date | 02/16/2011
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Last Update Date | 02/16/2011
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Provider Practice Location Address
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Address Line | 7975 LAKE UNDERHILL RD STE 210
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City | ORLANDO
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State | FL
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Zip | 32822-8204
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Country | US
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Telephone | 407-303-6830
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Fax |
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Provider Business Mailing Address
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Address Line | 3345 FURLONG WAY
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City | GOTHA
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State | FL
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Zip | 34734-5120
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Country | US
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Telephone | 717-343-7090
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | UO2569
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License Number State | FL
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