# PANDYA & NIME MD PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pathology and Medical Laboratory Diagnostic Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932175502
- **Authorized official:** SHONDELL BOUIE MD (PRESIDENT)
- **Authorized official phone:** (321) 636-2211

## Contact information

- **Practice address:** 110 LONGWOOD AVE, ROCKLEDGE, FL 32955-2828
- **Practice address phone:** (321) 636-2211
- **Practice address fax:** (321) 633-7085
- **Mailing address:** PO BOX 1943, INDIANAPOLIS, IN 46206-1943
- **Mailing address phone:** (877) 261-9061

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | Yes |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/24/2006
- **Last updated:** 02/08/2022