Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | ME115872 | FL |
NPI | 1003052945 |
---|---|
Provider Name | Chhavi Gupta |
First Address | Tampa, FL 33609-4181 |
Second Address | Tampa, FL 33609-3718 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/12/2008 |
Last Update Date | 15/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
106046200 | (05) | FL |