Individual
DR. LUIS A GANDARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 PLATINUM PT, LAKE MARY, FL 32746-4871
(407) 206-4500
(407) 643-2802
Mailing address
701 PLATINUM PT, LAKE MARY, FL 32746-4871
(407) 206-4500
(407) 643-2802
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
16675
PR
208100000X
Physical Medicine & Rehabilitation Physician
MD 440572
PA
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
ME109856
FL
Other
Enumeration date
06/13/2007
Last updated
11/04/2020
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