Organization
ORMOND BEACH MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDEEP GAZAHI (MANAGING MEMBER)
(646) 209-5519
Entity
Organization
Contact information
Practice address
725 W GRANADA BLVD STE 1, ORMOND BEACH, FL 32174-9406
(646) 209-5519
Mailing address
1415 OCEAN SHORE BLVD APT 309, ORMOND BEACH, FL 32176-3642
(646) 209-5519
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
10/20/2021
Last updated
10/20/2021
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