Provider Demographics
NPI:1144967431
Name:ELON HEALTH
Entity type:Organization
Organization Name:ELON HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:PANDYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-508-5254
Mailing Address - Street 1:127 W FAIRBANKS AVE STE 447
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4326
Mailing Address - Country:US
Mailing Address - Phone:352-508-5254
Mailing Address - Fax:352-508-5325
Practice Address - Street 1:43378 HIGHWAY 27 STE A
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-6816
Practice Address - Country:US
Practice Address - Phone:352-508-5254
Practice Address - Fax:352-508-5325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-18
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1770570558OtherNPPES