MEDICARE: SANJAY NARI KHUBCHANDANI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	ME97762	FL
2	2080P0206X	Pediatric Gastroenterology Physician	ME97762	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093866972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANJAY NARI KHUBCHANDANI MD

Provider Business Mailing Address
First Line	:	6735 CONROY WINDERMERE RD
Second Line	:	SUITE 226
City	:	ORLANDO
State	:	FL
Zip	:	32835-3565
Country	:	US
Telephone Number	:	407-438-3557
Fax Number	:	407-438-3558

Provider Business Practice Location Address
First Line	:	6735 CONROY WINDERMERE RD
Second Line	:	SUITE 226
City	:	ORLANDO
State	:	FL
Zip	:	32835-3565
Country	:	US
Telephone Number	:	407-438-3557
Fax Number	:	407-438-3558

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	08/28/2024

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