Provider Demographics
NPI:1477998599
Name:PANDYA, KAYLESH KUMAR (DO)
Entity Type:Individual
Prefix:DR
First Name:KAYLESH
Middle Name:KUMAR
Last Name:PANDYA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 N UNIVERSITY DR STE 500-52
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2002
Mailing Address - Country:US
Mailing Address - Phone:276-835-3633
Mailing Address - Fax:768-353-6332
Practice Address - Street 1:261 N UNIVERSITY DR STE 500-52
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2002
Practice Address - Country:US
Practice Address - Phone:276-835-3633
Practice Address - Fax:276-835-3633
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-02
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS14868204D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM