Individual
DR. PREETHAM GRANDHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1324 LAKELAND HILLS BLVD, LAKELAND, FL 33805-4543
(863) 687-1222
(863) 603-6546
Mailing address
28564 PICANA LN, WESLEY CHAPEL, FL 33543-6659
(914) 262-2170
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
214467
NY
2084P0800X
Psychiatry Physician
37805
CT
2084P0800X
Psychiatry Physician
ME137963
FL
2084P0804X
Child & Adolescent Psychiatry Physician
214467
NY
2084P0804X
Child & Adolescent Psychiatry Physician
37805
CT
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
ME137963
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
214467
LICENSE
NY
01
—
37805
LICENSE
CT
01
—
ME137963
LICENSE
FL
Enumeration date
07/31/2006
Last updated
03/07/2023
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