Provider Demographics
NPI:1689777617
Name:VIPUL V KABARIA MD PA
Entity Type:Organization
Organization Name:VIPUL V KABARIA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIPUL
Authorized Official - Middle Name:V
Authorized Official - Last Name:KABARIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-963-2200
Mailing Address - Street 1:PO BOX 272166
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33688-2166
Mailing Address - Country:US
Mailing Address - Phone:813-963-2200
Mailing Address - Fax:813-963-2700
Practice Address - Street 1:13910 N DALE MABRY HWY
Practice Address - Street 2:BLDG 4, STE 1
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2440
Practice Address - Country:US
Practice Address - Phone:813-963-2200
Practice Address - Fax:813-963-2700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208VP0000X
FLME66919208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDR424BMedicare PIN
FLDR424AMedicare PIN