Provider Demographics
NPI:1376112235
Name:PANDYA, KEYA (PA-C)
Entity Type:Individual
Prefix:
First Name:KEYA
Middle Name:
Last Name:PANDYA
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:70 ENDICOTT ST UNIT 1106
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-3047
Mailing Address - Country:US
Mailing Address - Phone:317-728-6910
Mailing Address - Fax:
Practice Address - Street 1:2150 S ANDREWS AVE STE 100
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-3496
Practice Address - Country:US
Practice Address - Phone:954-463-6408
Practice Address - Fax:954-463-1858
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2022-09-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9114544363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical