Provider Demographics
NPI:1326183815
Name:TRIPATHI, SHREEKANT K (MD)
Entity Type:Individual
Prefix:DR
First Name:SHREEKANT
Middle Name:K
Last Name:TRIPATHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1324 LAKELAND HILLS BLVD
Mailing Address - Street 2:ATTN: MEDICAL STAFF OFFICE
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-4543
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:520 E GARDEN ST
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-4616
Practice Address - Country:US
Practice Address - Phone:863-688-0536
Practice Address - Fax:863-688-0639
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2015-07-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME42352208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL53671OtherBCBS NUMBER
FL1326183815OtherNPI
FLD56627Medicare UPIN