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Individual

DR. SUDHIR HANSALIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3611 LITTLE RD, TRINITY, FL 34655-1813
(727) 312-4300
(727) 413-4335
Mailing address
5000 PARK ST N STE 1017, ST PETERSBURG, FL 33709-2236
(727) 344-6570
(727) 384-4388

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
ME114725
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
018165100
FLORIDA MEDICAID ID
FL
01
6VBQR
BCBS FL
FL
05
8528341
FL
01
KX084
MEDICARE
FL
01
KX085
MEDICARE
FL
Enumeration date
05/02/2007
Last updated
08/31/2020
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