Provider Demographics
NPI:1467151522
Name:PANDYA, ASHUTOSH N
Entity Type:Individual
Prefix:
First Name:ASHUTOSH
Middle Name:N
Last Name:PANDYA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7211 N DALE MABRY HWY STE 223
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-2669
Mailing Address - Country:US
Mailing Address - Phone:813-541-8550
Mailing Address - Fax:
Practice Address - Street 1:7211 N DALE MABRY HWY STE 223
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2669
Practice Address - Country:US
Practice Address - Phone:813-541-8550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-28
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care