Provider Demographics
NPI:1053348052
Name:GIDWANI, MONALI LAXPATI (MD)
Entity type:Individual
Prefix:
First Name:MONALI
Middle Name:LAXPATI
Last Name:GIDWANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MONALI
Other - Middle Name:JATIN
Other - Last Name:LAXPATI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:703 N FLAMINGO RD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1006
Mailing Address - Country:US
Mailing Address - Phone:954-844-1300
Mailing Address - Fax:954-844-1310
Practice Address - Street 1:703 N FLAMINGO RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1006
Practice Address - Country:US
Practice Address - Phone:954-844-1300
Practice Address - Fax:954-844-1310
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME111199207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine