Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME144714 | FL |
N | 111NI0900X | Internist | ME144714 | FL |
N | 207RH0000X | Hematologist | ME144714 | FL |
Y | 207RX0202X | Medical Oncology | ME144714 | FL |
NPI | 1467649368 |
---|---|
Provider Name | Shaachi Gupta |
First Address | Fort Myers, FL 33916-2216 |
Second Address | Palm Springs, FL 33461-4746 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2007 |
Last Update Date | 11/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
107278400 | (05) | FL |