Provider Demographics
NPI:1982686135
Name:BANDEALY, KARAMALI ABDULSULTAN (MD,)
Entity Type:Individual
Prefix:DR
First Name:KARAMALI
Middle Name:ABDULSULTAN
Last Name:BANDEALY
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 1:1020 W OAK ST
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741
Mailing Address - Country:US
Mailing Address - Phone:407-870-1579
Mailing Address - Fax:407-870-2353
Practice Address - Street 1:1020 W OAK ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741
Practice Address - Country:US
Practice Address - Phone:407-870-1579
Practice Address - Fax:407-870-2353
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-15
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0056593207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL09685ZMedicare PIN