Individual
PRABHAT K TANDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10250 SE 167TH PLACE RD, SUITE 5-1, SUMMERFIELD, FL 34491-8686
(352) 307-9925
(342) 307-8442
Mailing address
10250 SE 167TH PLACE RD UNIT 5, SUMMERFIELD, FL 34491-8682
(352) 307-9925
(352) 307-8442
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
25MA07690200
NJ
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
MD072463L
PA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
ME118191
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011902800
—
FL
Enumeration date
07/11/2006
Last updated
01/12/2018
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