Provider Demographics
NPI:1013208057
Name:SIROHI, MOHIT (MD)
Entity Type:Individual
Prefix:
First Name:MOHIT
Middle Name:
Last Name:SIROHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 DAVIS BLVD.
Mailing Address - Street 2:#604
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606
Mailing Address - Country:US
Mailing Address - Phone:813-258-9565
Mailing Address - Fax:813-258-3535
Practice Address - Street 1:1 DAVIS BLVD.
Practice Address - Street 2:#604
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606
Practice Address - Country:US
Practice Address - Phone:813-258-9565
Practice Address - Fax:813-258-3535
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-25
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101260296208800000X
FLME132364208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLJA084ZOtherPROVIDER MEDICARE
VAA180OtherGROUP MEDICARE NSC
VAVVL132A180OtherPROVIDER MEDICARE NSC