Provider Demographics
NPI:1225182918
Name:VERMA, DEEPA BOGLE (MD)
Entity Type:Individual
Prefix:DR
First Name:DEEPA
Middle Name:BOGLE
Last Name:VERMA
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 10744
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33757-8744
Mailing Address - Country:US
Mailing Address - Phone:727-532-0002
Mailing Address - Fax:
Practice Address - Street 1:3165 N MCMULLEN BOOTH RD STE D-2
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2020
Practice Address - Country:US
Practice Address - Phone:727-754-2936
Practice Address - Fax:277-542-9377
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95465207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL280773400Medicaid
FLP00673371OtherRAILROAD MEDICARE PROVIDER NUMBER
FLP00673371OtherRAILROAD MEDICARE PROVIDER NUMBER
FLAJ425XMedicare PIN