Provider Demographics
NPI:1730368796
Name:DR. DARYANANI INC.
Entity type:Organization
Organization Name:DR. DARYANANI INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:LAXMICHAND
Authorized Official - Middle Name:
Authorized Official - Last Name:DARYANANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-465-1110
Mailing Address - Street 1:14501 AMACA CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-7155
Mailing Address - Country:US
Mailing Address - Phone:407-856-4720
Mailing Address - Fax:
Practice Address - Street 1:8216 WORLD CENTER DR
Practice Address - Street 2:SUITE D
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32821-5412
Practice Address - Country:US
Practice Address - Phone:407-465-1110
Practice Address - Fax:407-465-1222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-26
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME27341207Q00000X
FLME 27341261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL260382901Medicaid
FLG44067Medicare UPIN