Provider Demographics
NPI:1033193305
Name:SAPROUNOVA, VERA (MD)
Entity Type:Individual
Prefix:
First Name:VERA
Middle Name:
Last Name:SAPROUNOVA
Suffix:
Gender:F
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:PO BOX 1289
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33509-1289
Mailing Address - Country:US
Mailing Address - Phone:813-684-8020
Mailing Address - Fax:813-662-6968
Practice Address - Street 1:1426 BLOOMINGDALE AVE
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33594-6110
Practice Address - Country:US
Practice Address - Phone:813-684-8020
Practice Address - Fax:813-662-6968
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-01
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME91078207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270710100Medicaid
FLK8098Medicare ID - Type UnspecifiedGROUP
H76701Medicare UPIN
FL270710100Medicaid