Organization
BREVARD DERMPATH AND SURGPATH LAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUMANT PANDYA MD (PRESIDENT)
(305) 702-5135
Entity
Organization
Contact information
Practice address
830 EXECUTIVE LN, SUITE #150, ROCKLEDGE, FL 32955-3595
(305) 702-5135
Mailing address
2555 PONCE DE LEON BLVD, 4TH FLOOR, CORAL GABLES, FL 33134-6010
(305) 702-5135
(305) 441-2144
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
09/20/2006
Last updated
06/10/2008
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