Provider Demographics
NPI:1558654079
Name:CHANDY, JOSHUA KORA (DO)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:KORA
Last Name:CHANDY
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 1:7814 N DALE MABRY HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-3220
Mailing Address - Country:US
Mailing Address - Phone:813-405-3938
Mailing Address - Fax:
Practice Address - Street 1:7814 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-3220
Practice Address - Country:US
Practice Address - Phone:813-405-3938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-17
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0735232084P0800X
FLOS137822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry