Provider Demographics
NPI:1144423195
Name:BHANDARE, SUNITA PRAKASH (MD)
Entity Type:Individual
Prefix:
First Name:SUNITA
Middle Name:PRAKASH
Last Name:BHANDARE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5003 WATERKEY WAY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2787
Mailing Address - Country:US
Mailing Address - Phone:410-370-1630
Mailing Address - Fax:
Practice Address - Street 1:5003 WATERKEY WAY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2787
Practice Address - Country:US
Practice Address - Phone:410-370-1630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME116329208000000X
FLME 1163292080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics