Provider Demographics
NPI:1174520456
Name:SAWHNEY, SUMAN K (MD)
Entity type:Individual
Prefix:DR
First Name:SUMAN
Middle Name:K
Last Name:SAWHNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6900 TAVISTOCK LAKES BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-7592
Mailing Address - Country:US
Mailing Address - Phone:321-332-6947
Mailing Address - Fax:407-286-4515
Practice Address - Street 1:2185 CHENEY HWY
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32780-6700
Practice Address - Country:US
Practice Address - Phone:321-269-9800
Practice Address - Fax:321-269-7082
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY146071207R00000X
FLME135082207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00842668Medicaid
NYA400113954Medicare PIN
NY24D171Medicare ID - Type Unspecified