Provider Demographics
NPI:1427044502
Name:SINGH, VIBHUTI N (MD)
Entity Type:Individual
Prefix:
First Name:VIBHUTI
Middle Name:N
Last Name:SINGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 6TH ST S
Mailing Address - Street 2:BLDG B, RM 279
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4814
Mailing Address - Country:US
Mailing Address - Phone:727-893-6283
Mailing Address - Fax:727-893-6914
Practice Address - Street 1:901 22ND AVE S
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-2933
Practice Address - Country:US
Practice Address - Phone:727-310-0925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD25036207RI0011X
FLME64797207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL262790600Medicaid
FL262790600Medicaid
FL25515UMedicare PIN