Provider Demographics
NPI:1275796294
Name:SARANGA-PERRY, VITA (MD)
Entity Type:Individual
Prefix:DR
First Name:VITA
Middle Name:
Last Name:SARANGA-PERRY
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:727-266-4928
Practice Address - Street 1:1601 W TIMBERLANE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33566-0957
Practice Address - Country:US
Practice Address - Phone:813-708-1312
Practice Address - Fax:813-321-1877
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME108625207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006262500Medicaid