Individual
SUMATHI RAJA CHANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1350 HICKORY ST, MELBOURNE, FL 32901
(321) 434-1771
(321) 434-1775
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME113198
FL
208M00000X
Hospitalist Physician
Primary
ME113198
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019432700
—
FL
01
—
HK821Y
FL MEDICARE
FL
01
—
P01760214
FL RR MEDICARE
FL
Enumeration date
05/28/2009
Last updated
03/25/2024
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