Provider Demographics
NPI:1275962839
Name:HINA T. GUPTA MD PA
Entity Type:Organization
Organization Name:HINA T. GUPTA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HINA
Authorized Official - Middle Name:T
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-755-4002
Mailing Address - Street 1:5511 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 101B
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-4646
Mailing Address - Country:US
Mailing Address - Phone:954-755-4002
Mailing Address - Fax:954-755-5010
Practice Address - Street 1:5511 N UNIVERSITY DR
Practice Address - Street 2:SUITE 101B
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-4646
Practice Address - Country:US
Practice Address - Phone:954-755-4002
Practice Address - Fax:954-755-5010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME113564207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLR7431Medicare UPIN