Organization
AMITABH GUPTA MD PA
Active
Other names
COASTAL ORTHOPEDIC MEDICINE, PAIN MANAGEMENT & REHAB
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMITABH P GUPTA MD (PRESIDENT)
(727) 526-8000
Entity
Organization
Contact information
Practice address
7895 SEMINOLE BLVD, SUITE# 101, SEMINOLE, FL 33772-4891
(727) 526-8000
Mailing address
5800 49TH ST N, SUITE S 205, ST PETERSBURG, FL 33709-2146
(727) 526-8000
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME85225
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17034
BLUE CROSS BLUE SHIELD
FL
05
—
2744716
—
FL
01
—
299916
AVMED
FL
01
—
304583
WELLCARE
FL
01
—
7966328
AETNA
FL
Enumeration date
10/22/2008
Last updated
12/12/2011
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