Provider Demographics
NPI:1124314703
Name:MANOHAR, AKSHAY (MD)
Entity type:Individual
Prefix:DR
First Name:AKSHAY
Middle Name:
Last Name:MANOHAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W GORE ST STE 605
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1051
Mailing Address - Country:US
Mailing Address - Phone:407-271-4731
Mailing Address - Fax:850-942-0322
Practice Address - Street 1:100 W GORE ST STE 605
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1051
Practice Address - Country:US
Practice Address - Phone:407-271-4731
Practice Address - Fax:407-271-4738
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME126953207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program