Provider Demographics
NPI:1750443016
Name:SANDHYA NEMADE, MD, PA
Entity Type:Organization
Organization Name:SANDHYA NEMADE, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANDHYA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEMADE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-771-8636
Mailing Address - Street 1:6405 N FEDERAL HWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-1412
Mailing Address - Country:US
Mailing Address - Phone:954-771-8636
Mailing Address - Fax:
Practice Address - Street 1:6405 N FEDERAL HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-1412
Practice Address - Country:US
Practice Address - Phone:954-771-8636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64571207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG06708Medicare UPIN
FLK5201Medicare ID - Type Unspecified