Provider Demographics
NPI:1508847070
Name:AMIN, DEVENDRA N (MD)
Entity Type:Individual
Prefix:
First Name:DEVENDRA
Middle Name:N
Last Name:AMIN
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 1:2410 NORTHSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-2236
Mailing Address - Country:US
Mailing Address - Phone:727-499-0356
Mailing Address - Fax:727-781-3312
Practice Address - Street 1:2305 KENT PL
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-7526
Practice Address - Country:US
Practice Address - Phone:727-286-2411
Practice Address - Fax:727-781-3312
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0057186207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL057861400Medicaid
FLP01027107OtherRR ,MEDICARE
14275AMedicare PIN
FLE45056Medicare UPIN
FL14275ZMedicare PIN