Provider Demographics
NPI:1811184583
Name:VIPUL JOSHI, MD PA
Entity type:Organization
Organization Name:VIPUL JOSHI, MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VIPUL
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-651-4441
Mailing Address - Street 1:PO BOX 1192
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33509-1192
Mailing Address - Country:US
Mailing Address - Phone:813-651-4441
Mailing Address - Fax:813-661-3374
Practice Address - Street 1:1355 PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4885
Practice Address - Country:US
Practice Address - Phone:813-651-4441
Practice Address - Fax:813-661-3374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87414207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDP3218OtherRAILROAD MEDICARE GROUP #