Provider Demographics
NPI:1497975304
Name:MISHRA, APARAJITA (MD)
Entity Type:Individual
Prefix:
First Name:APARAJITA
Middle Name:
Last Name:MISHRA
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 1:1001 E BAKER ST STE 400
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-3700
Mailing Address - Country:US
Mailing Address - Phone:813-708-0164
Mailing Address - Fax:813-708-0165
Practice Address - Street 1:1001 E BAKER ST STE 400
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-3700
Practice Address - Country:US
Practice Address - Phone:813-708-0164
Practice Address - Fax:813-708-0165
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL133536207Q00000X
TX44236207Q00000X
SC32056207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLJB637ZOtherMEDICARE
FL023125200Medicaid
OK200481950 AMedicaid
TX317381701Medicaid
TX8GE544OtherBCBS OF TEXAS
SC320566Medicaid
TX8GE544OtherBCBS OF TEXAS
NM26370361Medicaid
SC320566Medicaid