Individual
DR. PETER PAYTHAL GANPAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10129 CLEAR VISTA ST, ORLANDO, FL 32832-7164
(833) 663-6331
(833) 673-0418
Mailing address
425 W COLONIAL DR STE 302, ORLANDO, FL 32804-6863
(407) 601-1370
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2014-01754
NC
207Q00000X
Family Medicine Physician
ME130503
FL
2084P0800X
Psychiatry Physician
2014-01754
NC
2084P0800X
Psychiatry Physician
Primary
ME130503
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
QP578
MEDICARE HF
FL
Enumeration date
05/18/2010
Last updated
04/18/2023
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