Individual
VASUNDHARA G IYENGAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M. D.
Contact information
Practice address
1920 DON WICKHAM DR STE 100, CLERMONT, FL 34711-1977
(352) 394-1150
(352) 394-1560
Mailing address
4371 VERONICA S SHOEMAKER BLVD, ATTN: CREDENTIAL DEPARTMENT, FORT MYERS, FL 33916-2216
(239) 274-8200
(239) 278-3350
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
ME0044726
FL
207RX0202X
Medical Oncology Physician
Primary
ME0044726
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040458600
—
FL
Enumeration date
04/20/2006
Last updated
11/13/2021
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