Provider Demographics
NPI:1275506875
Name:GUPTA, SNEH L (MD)
Entity Type:Individual
Prefix:
First Name:SNEH
Middle Name:L
Last Name:GUPTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1619
Mailing Address - Street 2:
Mailing Address - City:ELFERS
Mailing Address - State:FL
Mailing Address - Zip Code:34680-1619
Mailing Address - Country:US
Mailing Address - Phone:727-844-3351
Mailing Address - Fax:727-847-7685
Practice Address - Street 1:5340 GULF DR
Practice Address - Street 2:SUITE 105
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-3950
Practice Address - Country:US
Practice Address - Phone:727-844-3351
Practice Address - Fax:727-847-7685
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME-58176207RH0003X
FLME58176207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL26406OtherBCBS
P00732718OtherRAILROAD MCR WITH GROUP DP1381
P00788155OtherRAILROAD MEDICARE UNDER SSN
FL377594100Medicaid
830001857OtherRAILROAD MEDICARE
FLF96128Medicare UPIN
FL26406ZMedicare PIN
830001857OtherRAILROAD MEDICARE
FL377594100Medicaid
FL26406XMedicare PIN