Basic Information
| Provider Information | |||||||||
| NPI: | 1386807857 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUNDALANI | ||||||||
| FirstName: | SHILPA | ||||||||
| MiddleName: | GOBIND | ||||||||
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| Mailing Information | |||||||||
| Address1: | 215 GRAND AVE | ||||||||
| Address2: | |||||||||
| City: | CORAL GABLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331334841 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 215 GRAND AVE | ||||||||
| Address2: | |||||||||
| City: | CORAL GABLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331334841 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054417179 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2008 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MD443161 | PA | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080N0001X | ME134709 | FL | Y | Allopathic & Osteopathic Physicians | Pediatrics | Neonatal-Perinatal Medicine | 390200000X | BP10039246 | TX | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.