Provider Demographics
NPI:1386816379
Name:ASOPA, AMIT (MD,FRCA)
Entity Type:Individual
Prefix:DR
First Name:AMIT
Middle Name:
Last Name:ASOPA
Suffix:
Gender:M
Credentials:MD,FRCA
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 9033
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34995-9033
Mailing Address - Country:US
Mailing Address - Phone:772-223-2832
Mailing Address - Fax:772-223-5646
Practice Address - Street 1:509 SE RIVERSIDE DR STE 203
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2579
Practice Address - Country:US
Practice Address - Phone:772-288-5862
Practice Address - Fax:772-288-5874
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA246983207L00000X
KY45130207LP2900X
FLME132163207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLYH38QOtherFLORIDA BLUE
FL022432100Medicaid