Provider Demographics
NPI:1801853171
Name:CHANDRA, SUMEET (MD)
Entity Type:Individual
Prefix:DR
First Name:SUMEET
Middle Name:
Last Name:CHANDRA
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 1:2290 W EAU GALLIE BLVD
Mailing Address - Street 2:STE 202
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-3145
Mailing Address - Country:US
Mailing Address - Phone:321-254-4776
Mailing Address - Fax:321-254-4840
Practice Address - Street 1:2290 W EAU GALLIE BLVD
Practice Address - Street 2:STE 202
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-3145
Practice Address - Country:US
Practice Address - Phone:321-254-4776
Practice Address - Fax:321-254-4840
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 101674207RH0003X
FLME101674207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAN624YMedicare PIN
FLI59495Medicare UPIN