Provider Demographics
NPI:1205826542
Name:GHANEKAR, DEVYANI D (M D)
Entity Type:Individual
Prefix:DR
First Name:DEVYANI
Middle Name:D
Last Name:GHANEKAR
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5626 GULF DR
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-4020
Mailing Address - Country:US
Mailing Address - Phone:727-841-8212
Mailing Address - Fax:727-844-3092
Practice Address - Street 1:5626 GULF DR
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-4020
Practice Address - Country:US
Practice Address - Phone:727-841-8212
Practice Address - Fax:727-844-3092
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1428572085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL49815OtherBCBS
FLH13918Medicare UPIN
FL49815Medicare ID - Type UnspecifiedMEDICARE NUMBER