Provider Demographics
NPI:1093336646
Name:TOMAR, SANJEEVANI (MD)
Entity Type:Individual
Prefix:DR
First Name:SANJEEVANI
Middle Name:
Last Name:TOMAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SANJEEVANI KUMAR
Other - Middle Name:
Other - Last Name:TOMAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2501 N ORANGE AVE STE 235
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4659
Mailing Address - Country:US
Mailing Address - Phone:407-576-8068
Mailing Address - Fax:407-303-7323
Practice Address - Street 1:2501 N ORANGE AVE STE 235
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4659
Practice Address - Country:US
Practice Address - Phone:407-576-8068
Practice Address - Fax:407-303-7323
Is Sole Proprietor?:No
Enumeration Date:2020-05-05
Last Update Date:2023-06-29
Deactivation Date:2022-01-11
Deactivation Code:
Reactivation Date:2022-01-27
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program