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Organization
AMITABH GUPTA MD PA
Active
Organization
AMITABH GUPTA MD PA
Active
Other names
COASTAL ORTHOPEDIC MEDICINE, PAIN MANAGEMENT & REHAB
Organization subpart
No
Provider details
NPI number
Authorized official
AMITABH P GUPTA MD (PRESIDENT)
(727) 526-8000
Entity
Organization
Contact information
Practice address
5800 49TH ST N, SUITE S-205, ST PETERSBURG, FL 33709-2146
(727) 526-8000
(727) 521-2600
Mailing address
5800 49TH ST N, SUITE S-205, ST PETERSBURG, FL 33709-2146
(727) 526-8000
(727) 521-2600
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
ME85225
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17034
BL CRS/BL SHLD PROVIDER #
FL
05
—
2744716
—
FL
01
—
2799066
GHI PROVIDER NO.
FL
01
—
299916
AVMED PROVIDER NO.
FL
01
—
304583
WELLCARE PROVIDER NO.
FL
01
—
79665328
AETNA PROVIDER NO.
FL
01
—
AS34873800001
CIGNA PROVIDER NO.
FL
Enumeration date
04/04/2006
Last updated
12/26/2008
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