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NPI Code Detail

MEDICARE: DR. PRACHI GANDHI DO

MEDICARE: DR. PRACHI GANDHI DO
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
1207Q00000XFamily Medicine PhysicianOS10323FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1OS 10323OTHERFLFLORIDA MEDICAL LICENSE
2036116471OTHERILLICENSE NUMBER
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619081023
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PRACHI GANDHI DO
Provider Business Mailing Address
First Line : 1027 TOWN CENTER DRIVE
Second Line :
City : ORANGE CITY
State : FL
Zip : 32763-8360
Country : US
Telephone Number : 386-218-0222
Fax Number : 386-218-0201
Provider Business Practice Location Address
First Line : 1027 TOWN CENTER DRIVE
Second Line :
City : ORANGE CITY
State : FL
Zip : 32763-8360
Country : US
Telephone Number : 386-218-0222
Fax Number : 386-218-0201
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2006
Last Update Date : 02/06/2019

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