Provider Demographics
NPI:1356398200
Name:PANKHANIYA, ROHIT (MD)
Entity type:Individual
Prefix:DR
First Name:ROHIT
Middle Name:
Last Name:PANKHANIYA
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 1:3221 TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-8002
Mailing Address - Country:US
Mailing Address - Phone:941-505-8720
Mailing Address - Fax:941-505-0156
Practice Address - Street 1:3221 TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-8002
Practice Address - Country:US
Practice Address - Phone:941-505-8720
Practice Address - Fax:941-505-0156
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98038207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL53646OtherBCBS FL
MI1103312362OtherBCBS/BCN
MI1018248OtherMCLAREN HEALTH ADVANTAGE
MI1018248OtherMCLAREN HEALTH PLAN
MI4841702Medicaid
MI31-70042OtherPHP FAMILYCARE
MI7769649OtherAETNA
MI4706969Medicaid
FL7769649OtherAETNA
FLP00653208Medicare PIN
MI1018248OtherMCLAREN HEALTH PLAN
FL53646OtherBCBS FL
FLAW734ZMedicare PIN