Provider Demographics
NPI:1740465707
Name:BHANDARY, AVINASH KRISHNA (MD)
Entity type:Individual
Prefix:DR
First Name:AVINASH
Middle Name:KRISHNA
Last Name:BHANDARY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 N DONNELLY ST
Mailing Address - Street 2:STE 107
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757-2846
Mailing Address - Country:US
Mailing Address - Phone:407-605-5621
Mailing Address - Fax:
Practice Address - Street 1:6909 OLD HIGHWAY 441 S
Practice Address - Street 2:SUITE 104
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-7039
Practice Address - Country:US
Practice Address - Phone:407-605-5621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2018-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 1141432081P2900X, 2081P2900X
CT390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14ME6OtherBCBS
FL14ME6OtherBCBS