Provider Demographics
NPI:1679910863
Name:KAPADIA, POONAM KALIDAS (MD)
Entity Type:Individual
Prefix:DR
First Name:POONAM
Middle Name:KALIDAS
Last Name:KAPADIA
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 100226
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0226
Mailing Address - Country:US
Mailing Address - Phone:352-559-5051
Mailing Address - Fax:352-265-8018
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-6511
Practice Address - Country:US
Practice Address - Phone:352-265-8352
Practice Address - Fax:904-244-5359
Is Sole Proprietor?:No
Enumeration Date:2013-05-28
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME125165207RE0101X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108232300Medicaid