Provider Demographics
NPI:1114980075
Name:GUPTA, BHARAT KUMAR (MD, FACP)
Entity Type:Individual
Prefix:DR
First Name:BHARAT
Middle Name:KUMAR
Last Name:GUPTA
Suffix:
Gender:M
Credentials:MD, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 E OAKLAND PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-2725
Mailing Address - Country:US
Mailing Address - Phone:954-727-2300
Mailing Address - Fax:954-727-2301
Practice Address - Street 1:911 E OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-2725
Practice Address - Country:US
Practice Address - Phone:954-727-2300
Practice Address - Fax:954-727-2301
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME75767207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL253994200Medicaid
FLK2827OtherGROUP ID NUMBER
FL253994200Medicaid
FLG67979Medicare UPIN