MEDICARE: GAYATRI PANDEY

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	363LF0000X	Family Nurse Practitioner	11027460	FL

General Provider Information

NPI Number	:	1891474482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAYATRI PANDEY

Provider Business Mailing Address
First Line	:	20309 CHESTNUT GROVE DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3345
Country	:	US
Telephone Number	:	813-527-1193
Fax Number	:

Provider Business Practice Location Address
First Line	:	20309 CHESTNUT GROVE DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3345
Country	:	US
Telephone Number	:	813-527-1193
Fax Number	:

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

Provider Enumeration Date	:	07/12/2023
Last Update Date	:	07/12/2023

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Directions to “ GAYATRI PANDEY ” Practice Location

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