Provider Demographics
NPI:1578559993
Name:GHANEKAR, DILIP V (MD)
Entity Type:Individual
Prefix:
First Name:DILIP
Middle Name:V
Last Name:GHANEKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10820 STATE ROAD 54
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-2291
Mailing Address - Country:US
Mailing Address - Phone:727-846-7031
Mailing Address - Fax:727-846-7132
Practice Address - Street 1:10820 STATE ROAD 54
Practice Address - Street 2:SUITE 201
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-2291
Practice Address - Country:US
Practice Address - Phone:727-846-7031
Practice Address - Fax:727-846-7132
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0078829207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL258073000Medicaid
FL258073000Medicaid