Provider Demographics
NPI:1598939357
Name:SURABHI, SWAPNA
Entity Type:Individual
Prefix:
First Name:SWAPNA
Middle Name:
Last Name:SURABHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11901 4TH ST N
Mailing Address - Street 2:#7101
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-1724
Mailing Address - Country:US
Mailing Address - Phone:727-482-2975
Mailing Address - Fax:
Practice Address - Street 1:100 SOUTH NEWELL DRIVE
Practice Address - Street 2:MCKNIGHT BRAIN INSTITUTE L3-100
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610
Practice Address - Country:US
Practice Address - Phone:352-273-5549
Practice Address - Fax:352-273-5575
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN121072084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology