Individual provider Active NPI

Chantal Soobhanath, MD

  • Pediatrics Physician
  • Sanford, FL
National Provider Identifier
1881206266
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME160245 Issued in FL
Practice address
1403 Medical Plaza Dr
Sanford, FL 32771-1000
Phone
(407) 656-0042
NPI assigned
Aug 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X ME160245 FL Primary

Addresses

Primary practice location

1403 Medical Plaza Dr
Sanford, FL 32771-1000

Mailing address

1403 Medical Plaza Dr
Sanford, FL 32771-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240611004336 FL Practitioner - Pediatric Medicine 9830517804 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Jul 29, 2024 Accepting new patients
Florida Hospital Medical Group Inc Pediatrics CurrentSince Jul 29, 2024 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

2200 Fowler Grove Blvd
Ste 220
Winter Garden, FL 34787
Phone (407) 646-0042

Interoperability endpoints

  • Direct secure messaging: csoobhanath127802@adventhealth.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1881206266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 MEDICAL PLAZA DR",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327711000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 MEDICAL PLAZA DR",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327711000",
            "telephone_number": "407-656-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOOBHANATH",
        "first_name": "CHANTAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-18",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME160245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, FL

Sources for this page

Verify at the official NPI Registry.