Provider Demographics
NPI:1134389364
Name:SANDHU, NEIL (MD)
Entity type:Individual
Prefix:
First Name:NEIL
Middle Name:
Last Name:SANDHU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:258 TREEMONTE DR STE 258
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-7945
Mailing Address - Country:US
Mailing Address - Phone:386-628-3376
Mailing Address - Fax:386-877-0188
Practice Address - Street 1:258 TREEMONTE DR STE 258
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-7945
Practice Address - Country:US
Practice Address - Phone:386-628-3376
Practice Address - Fax:386-877-0188
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME113104207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology