Provider Demographics
NPI:1033244645
Name:MEHTA, SAUMEEL RASHMIKANT (MD)
Entity Type:Individual
Prefix:
First Name:SAUMEEL
Middle Name:RASHMIKANT
Last Name:MEHTA
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 1:18934 N DALE MABRY HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33548-4914
Mailing Address - Country:US
Mailing Address - Phone:813-948-2679
Mailing Address - Fax:813-948-2694
Practice Address - Street 1:18934 N DALE MABRY HWY STE 101
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33548-4914
Practice Address - Country:US
Practice Address - Phone:813-948-2679
Practice Address - Fax:813-948-2694
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08091100208000000X
FLME105288208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty