Provider Demographics
NPI:1811921729
Name:PANDYA, SUNIL RAMESH (MD)
Entity type:Individual
Prefix:DR
First Name:SUNIL
Middle Name:RAMESH
Last Name:PANDYA
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 1:49 MADISON DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1322
Mailing Address - Country:US
Mailing Address - Phone:239-223-2275
Mailing Address - Fax:239-223-2275
Practice Address - Street 1:8300 COLLIER BLVD FL 1
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34114-3549
Practice Address - Country:US
Practice Address - Phone:239-354-6185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA51888207R00000X
NC2011-00027207R00000X
ALMD.35392207R00000X
AZ43799207R00000X
FLME83170208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH70734Medicare UPIN
FL48312YMedicare ID - Type UnspecifiedSUNIL PANDYA