Individual
DR. PRAVEEN K GOOTAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13000 BRUCE B. DOWNS BLVD, JAMES A. HALEY VA, TAMPA, FL 33612
(813) 972-2000
Mailing address
13000 BRUCE B DOWNS BLVD, BLDG 38, RM C373, TAMPA, FL 33612-4745
(813) 972-2000
(813) 341-8855
Taxonomy
Speciality
Code
Description
License number
State
2084P0301X
Brain Injury Medicine (Psychiatry & Neurology) Physician
ME99352
FL
2084P0800X
Psychiatry Physician
Primary
ME99352
FL
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
ME99352
FL
Other
Enumeration date
08/05/2007
Last updated
12/31/2019
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