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Individual

SANDEEP MUKERJEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
500 WINDERLEY PL STE 115, MAITLAND, FL 32751-7406
(407) 581-9180
(865) 560-7066
Mailing address
500 WINDERLEY PL STE 115, MAITLAND, FL 32751-7406
(407) 581-9180
(865) 560-7066

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
92701
SC
207L00000X
Anesthesiology Physician
Primary
ME62331
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050066861
RAILROAD MEDICARE
01
17818
BCBS
FL
05
3713270 00
FL
01
XXX-XX-1955
CHAMPUS / TRICARE SOUTH REGION
Enumeration date
07/16/2006
Last updated
08/16/2024
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