Provider Demographics
NPI:1114554870
Name:CHANDAN, NEHA (MD)
Entity type:Individual
Prefix:
First Name:NEHA
Middle Name:
Last Name:CHANDAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2191 9TH AVE N STE 100
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-7147
Mailing Address - Country:US
Mailing Address - Phone:815-545-2740
Mailing Address - Fax:
Practice Address - Street 1:2191 9TH AVE N STE 100
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-7147
Practice Address - Country:US
Practice Address - Phone:815-545-2740
Practice Address - Fax:727-493-9945
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME166893207NS0135X, 207ND0101X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207N00000XAllopathic & Osteopathic PhysiciansDermatology