Provider Demographics
NPI:1497857346
Name:HIMANSHU CHANDARANA MD PA
Entity Type:Organization
Organization Name:HIMANSHU CHANDARANA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HIMANSHU
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDARANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-345-8179
Mailing Address - Street 1:5800 49TH ST N STE 208
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33709-2100
Mailing Address - Country:US
Mailing Address - Phone:727-892-2928
Mailing Address - Fax:727-345-7484
Practice Address - Street 1:5800 49TH ST N STE 208
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-2100
Practice Address - Country:US
Practice Address - Phone:727-345-8179
Practice Address - Fax:727-345-7484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-02
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0044422207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DN3915OtherRAILROAD MEDICARE
DN3915OtherRAILROAD MEDICARE