Provider Demographics
NPI:1275055378
Name:REHMAN, PUNITA KAPADIA (OD)
Entity Type:Individual
Prefix:
First Name:PUNITA
Middle Name:KAPADIA
Last Name:REHMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 GOVERNORS SQUARE BLVD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-3069
Mailing Address - Country:US
Mailing Address - Phone:850-391-4680
Mailing Address - Fax:
Practice Address - Street 1:1505 GOVERNORS SQUARE BLVD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-3069
Practice Address - Country:US
Practice Address - Phone:850-391-4680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9263T152W00000X
FLOPC5555152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist