Pandya & Nime MD PA

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

Legal business name

PANDYA & NIME MD PA

Doing business as

Pathology and Medical Laboratory Diagnostic Services

Practice address

110 Longwood Ave
Rockledge, FL 32955-2828

Phone

(321) 636-2211

Fax

(321) 633-7085

NPI assigned

Feb 24, 2006

Organization subpart

No

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

Authorized official

Name

Shondell Bouie, MD

Title

President

Phone

(321) 636-2211

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Pathology and Medical Laboratory Diagnostic Services Doing business as

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nasreen Qazi, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Melbourne, FL
  • NPI 1265550115
  NPD (past)
• Philip C. Smith, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Cocoa Beach, FL
  • NPI 1366497620
  NPD (past)
• Shurun Zhao, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Tampa, FL
  • NPI 1578603767
  NPD (past)

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644278400000",
    "number": "1932175502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1943",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462061943",
            "telephone_number": "877-261-9061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LONGWOOD AVE",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552828",
            "telephone_number": "321-636-2211",
            "fax_number": "321-633-7085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANDYA & NIME MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-24",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A",
        "authorized_official_last_name": "BOUIE",
        "authorized_official_first_name": "SHONDELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-636-2211",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055386700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055386703",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pathology and Medical Laboratory Diagnostic Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pathology and Medical Laboratory Diagnostic Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lisa Pallay
• Palm Cottage Operator, LLC (Palm Cottages)
• Palm Tree Speech Therapy
• Kyla Renee Palmiter, RD LD/N
• Joelene Pamintuan
• Sumant J Pandya, MD
• Kristine Panning, LMHC
• Richard Pantano, CRNA
• Brittany Paquette
• Judith Parker

• Anatomic Pathology & Clinical Pathology Physician in Rockledge, FL
• Providers in Rockledge, FL by specialty
• Anatomic Pathology & Clinical Pathology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; 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.