# SUNIL GUPTA MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Retina Specialty Institute
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104493311
- **Authorized official:** SUNIL GUPTA MD (MANAGING PARTNER)
- **Authorized official phone:** (850) 476-6759

## Contact information

- **Practice address:** 10800 PANAMA CITY BEACH PKWY STE 300, PANAMA CITY BEACH, FL 32407-2532
- **Practice address phone:** (850) 250-2637
- **Practice address fax:** (850) 250-2636
- **Mailing address:** 5150 N DAVIS HWY, PENSACOLA, FL 32503-2030
- **Mailing address phone:** (850) 476-6759
- **Mailing address fax:** (850) 484-5222

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | — | NULL | — |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | — | — | — |

## Other

- **Enumeration date:** 06/07/2021
- **Last updated:** 06/07/2021