| A Gupta Md Pa | |
|
3300 W Lake Mary Blvd Lake Mary FL 32746-3570 | |
| (407) 321-7111 | |
| (407) 321-7446 |
| Full Name | A Gupta Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 3300 W Lake Mary Blvd, Lake Mary, Florida |
| Authorized Official Name and Position | Anita Gupta (PRESIDENT) |
| Authorized Official Contact | 4073217111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A Gupta Md Pa 3300 W Lake Mary Blvd Lake Mary FL 32746-3570 Ph: (407) 321-7111 | A Gupta Md Pa 3300 W Lake Mary Blvd Lake Mary FL 32746-3570 Ph: (407) 321-7111 |
| NPI Number | 1962636217 |
|---|---|
| Provider Enumeration Date | 05/14/2009 |
| Last Update Date | 05/14/2009 |
| Medicare PECOS PAC ID | 1456548007 |
|---|---|
| Medicare Enrollment ID | O20101208000371 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962636217 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME0073977 (Florida) | Primary |
| Provider Name | Anita Gupta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457332868 PECOS PAC ID: 2365639911 Enrollment ID: I20101208000501 |
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