Provider Demographics
NPI:1417150764
Name:GANDHI, RIPAL TARUN (MD)
Entity Type:Individual
Prefix:DR
First Name:RIPAL
Middle Name:TARUN
Last Name:GANDHI
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 1:8900 N KENDALL DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2118
Mailing Address - Country:US
Mailing Address - Phone:786-596-5990
Mailing Address - Fax:786-596-2999
Practice Address - Street 1:8900 N KENDALL DR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2118
Practice Address - Country:US
Practice Address - Phone:786-596-5990
Practice Address - Fax:786-596-2999
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA863462085R0202X, 2085R0204X
FLME1045272085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME104527OtherPRIVATE INSURANCE
CA00A863460OtherBLUE SHIELD
CA00A863460Medicaid
CAWA86346BMedicare PIN
CA00A863460OtherBLUE SHIELD
CAWA86346FMedicare PIN
CA00A863460Medicaid
CAWA86346CMedicare PIN