Provider Demographics
NPI:1922232347
Name:GOYAL, SUNALI (MD)
Entity Type:Individual
Prefix:
First Name:SUNALI
Middle Name:
Last Name:GOYAL
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:PO BOX 720956
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32872-0956
Mailing Address - Country:US
Mailing Address - Phone:407-243-8715
Mailing Address - Fax:407-326-6960
Practice Address - Street 1:10962 MOSS PARK RD STE 200
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-6399
Practice Address - Country:US
Practice Address - Phone:407-243-8715
Practice Address - Fax:407-326-6960
Is Sole Proprietor?:No
Enumeration Date:2009-05-13
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-9195207W00000X
FLME154235207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX387587401Medicaid
AR210492001Medicaid