Provider Demographics
NPI:1467417899
Name:AMBAY, APARNA R (MD)
Entity Type:Individual
Prefix:
First Name:APARNA
Middle Name:R
Last Name:AMBAY
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 1:2441 OAK MYRTLE LANE
Mailing Address - Street 2:101
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-6934
Mailing Address - Country:US
Mailing Address - Phone:813-406-4835
Mailing Address - Fax:813-994-4835
Practice Address - Street 1:2441 OAK MYRTLE LN STE 101
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-6334
Practice Address - Country:US
Practice Address - Phone:813-406-4835
Practice Address - Fax:813-994-4835
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME109584207N00000X, 207ND0101X
TXN3442207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
I56981Medicare UPIN
WIP00332854Medicare PIN
WI34710700Medicaid
I56981Medicare UPIN
WI60563OtherDEAN HEALTH INSURANCE
WI132313080Medicare PIN