Provider Demographics
NPI:1083175061
Name:AHLUWALIA, AMANDEEP (DO)
Entity type:Individual
Prefix:DR
First Name:AMANDEEP
Middle Name:
Last Name:AHLUWALIA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:52 UNDERWOOD ST # 153
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1110
Mailing Address - Country:US
Mailing Address - Phone:321-841-2558
Mailing Address - Fax:407-849-6470
Practice Address - Street 1:52 UNDERWOOD ST # 153
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1110
Practice Address - Country:US
Practice Address - Phone:321-841-2558
Practice Address - Fax:407-849-6470
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-31
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS221082085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL127619600Medicaid