Provider Demographics
NPI:1831466846
Name:KIRTIKUMAR J. PANDYA, M.D., PA
Entity Type:Organization
Organization Name:KIRTIKUMAR J. PANDYA, M.D., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRTIKUMAR
Authorized Official - Middle Name:J
Authorized Official - Last Name:PANDYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-353-0900
Mailing Address - Street 1:5106 N ARMENIA AVE
Mailing Address - Street 2:SUITE #3
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-1433
Mailing Address - Country:US
Mailing Address - Phone:813-353-0900
Mailing Address - Fax:813-353-0802
Practice Address - Street 1:5106 N ARMENIA AVE
Practice Address - Street 2:SUITE #3
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-1433
Practice Address - Country:US
Practice Address - Phone:813-353-0900
Practice Address - Fax:813-353-0802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-18
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1568408870OtherNPI
FLFP619AMedicare PIN