Provider Demographics
NPI:1164455770
Name:NIHALANI, SUNIL (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNIL
Middle Name:
Last Name:NIHALANI
Suffix:
Gender:M
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:PO BOX 25487
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34277-2487
Mailing Address - Country:US
Mailing Address - Phone:941-216-0072
Mailing Address - Fax:855-253-4836
Practice Address - Street 1:405 S 11TH ST
Practice Address - Street 2:
Practice Address - City:LAKE WALES
Practice Address - State:FL
Practice Address - Zip Code:33853-4202
Practice Address - Country:US
Practice Address - Phone:863-679-8000
Practice Address - Fax:863-679-8008
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME74564207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL74564OtherMEDICAL LICENSE
FL070257900Medicaid
FL44347OtherBLUE CROSS BLUE SHIELD
FL44347OtherBLUE CROSS BLUE SHIELD
G77478Medicare UPIN