Provider Demographics
NPI:1639153158
Name:SAXENA, SHILPA P (MD)
Entity Type:Individual
Prefix:
First Name:SHILPA
Middle Name:P
Last Name:SAXENA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:19105 US HIGHWAY 41 N
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33549-4258
Mailing Address - Country:US
Mailing Address - Phone:813-269-2700
Mailing Address - Fax:813-269-2701
Practice Address - Street 1:19105 US HIGHWAY 41 N
Practice Address - Street 2:SUITE 100
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-4258
Practice Address - Country:US
Practice Address - Phone:813-269-2700
Practice Address - Fax:813-269-2701
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2014-02-20
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Provider Licenses
StateLicense IDTaxonomies
FLME79414207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2619776-00Medicaid
FL2619776-00Medicaid
FLH54002Medicare UPIN