Provider Demographics
NPI:1245594241
Name:PUROHIT, SUGANDHA (MD)
Entity Type:Individual
Prefix:DR
First Name:SUGANDHA
Middle Name:
Last Name:PUROHIT
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 1:16500 GULF BLVD
Mailing Address - Street 2:UNIT 756
Mailing Address - City:NORTH REDINGTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33708-4420
Mailing Address - Country:US
Mailing Address - Phone:727-393-9309
Mailing Address - Fax:
Practice Address - Street 1:205 DR MARTIN LUTHER KING JR ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3109
Practice Address - Country:US
Practice Address - Phone:727-824-6900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79820207V00000X
OH043024207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology