Provider Demographics
NPI:1831360445
Name:GANDHI, PURVI B (PSYD)
Entity type:Individual
Prefix:
First Name:PURVI
Middle Name:B
Last Name:GANDHI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1969 S ALAFAYA TRL
Mailing Address - Street 2:# 186
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-8732
Mailing Address - Country:US
Mailing Address - Phone:407-730-9966
Mailing Address - Fax:
Practice Address - Street 1:1858 N ALAFAYA TRL
Practice Address - Street 2:SUITE 205
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32826-4728
Practice Address - Country:US
Practice Address - Phone:407-730-9966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-23
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7693103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist