Ormond Beach Medical LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

ORMOND BEACH MEDICAL LLC

Practice address

725 W Granada Blvd Ste 1
Ormond Beach, FL 32174-9406

Phone

(646) 209-5519

NPI assigned

Oct 20, 2021

Last updated

Oct 20, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sandeep Gazahi

Title

Managing Member

Phone

(646) 209-5519

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634688000000",
    "number": "1578226114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 OCEAN SHORE BLVD APT 309",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321763642",
            "telephone_number": "646-209-5519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 W GRANADA BLVD STE 1",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321749406",
            "telephone_number": "646-209-5519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORMOND BEACH MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-20",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A",
        "authorized_official_last_name": "GAZAHI",
        "authorized_official_first_name": "SANDEEP",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "646-209-5519"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.