Provider Demographics
NPI:1609866136
Name:DANDAPANI, BHUVANESWARI K (MD)
Entity Type:Individual
Prefix:
First Name:BHUVANESWARI
Middle Name:K
Last Name:DANDAPANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 S FISKE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4306
Mailing Address - Country:US
Mailing Address - Phone:321-473-4704
Mailing Address - Fax:321-951-7408
Practice Address - Street 1:1223 GATEWAY DR STE 2G
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-2607
Practice Address - Country:US
Practice Address - Phone:321-473-4704
Practice Address - Fax:321-725-7028
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME637072084V0102X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01164063OtherRRMR
FL18931XOtherMEDICARE HF
FL015931800Medicaid
FL130020876OtherRR MEDICARE