1275506875 NPI number — SNEH L GUPTA M.D.

Table of content: SNEH L GUPTA M.D. (NPI 1275506875)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275506875 NPI number — SNEH L GUPTA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GUPTA
Provider First Name:
SNEH
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275506875
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/21/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1619
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELFERS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34680-1619
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-844-3351
Provider Business Mailing Address Fax Number:
727-847-7685

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5340 GULF DR
Provider Second Line Business Practice Location Address:
SUITE 105
Provider Business Practice Location Address City Name:
NEW PORT RICHEY
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34652-3950
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-844-3351
Provider Business Practice Location Address Fax Number:
727-847-7685
Provider Enumeration Date:
02/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X , with the licence number:  ME-58176 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207R00000X , with the licence number: ME58176 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 26406 . This is a "BCBS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: P00732718 . This is a "RAILROAD MCR WITH GROUP DP1381" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00788155 . This is a "RAILROAD MEDICARE UNDER SSN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 377594100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 830001857 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".




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