Provider Demographics
NPI:1629086780
Name:AMIN, SANGEETA BHAGWATLAL (MD)
Entity Type:Individual
Prefix:
First Name:SANGEETA
Middle Name:BHAGWATLAL
Last Name:AMIN
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 1:57 CRABAPPLE LN
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-8106
Mailing Address - Country:US
Mailing Address - Phone:850-748-9026
Mailing Address - Fax:
Practice Address - Street 1:1717 N E ST STE 231
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-6390
Practice Address - Country:US
Practice Address - Phone:850-469-7975
Practice Address - Fax:850-469-2113
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01071295A207RH0003X
AL29647207RH0003X
MI4301104177207RH0003X
GA62306207RH0003X
OH72762207RH0003X
WV19002207RH0003X
NY197804207RH0003X
FLME94464207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL276254400Medicaid
FL56327OtherBS FLORIDA
AL009942962Medicaid
AL59187546OtherBSAL
FLAA489ZOtherMEDICARE
FL276254400Medicaid