Provider Demographics
NPI:1649373697
Name:KABARIA, VIPUL V (MD)
Entity type:Individual
Prefix:DR
First Name:VIPUL
Middle Name:V
Last Name:KABARIA
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: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:727-823-2188
Mailing Address - Fax:727-828-0723
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
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME66919207R00000X, 208VP0000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL28500OtherBCBS
FL050058540OtherRR MEDICARE
FL379601900Medicaid
FL24981OtherWELLCARE
9640232OtherGHI
FL28500OtherBCBS
FL28500UMedicare PIN
FL050058540OtherRR MEDICARE
FL28500BMedicare PIN