Provider Demographics
NPI:1659640654
Name:PAREEK, VIPUL GAURISHANKAR (MD)
Entity Type:Individual
Prefix:
First Name:VIPUL
Middle Name:GAURISHANKAR
Last Name:PAREEK
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 1:1300 W OAK ST
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4024
Mailing Address - Country:US
Mailing Address - Phone:407-944-5240
Mailing Address - Fax:407-944-5251
Practice Address - Street 1:1300 W OAK ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4024
Practice Address - Country:US
Practice Address - Phone:407-944-5240
Practice Address - Fax:407-944-5251
Is Sole Proprietor?:No
Enumeration Date:2011-12-20
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME146718207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program