Individual
PRATIBHA N GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
655 W 8TH ST, UFJP RADIOLOGY, JACKSONVILLE, FL 32209-6511
(904) 244-7244
Mailing address
PO BOX 44008, UFJP RADIOLOGY, JACKSONVILLE, FL 32231-4008
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
140723
NY
2085R0202X
Diagnostic Radiology Physician
Primary
ME102648
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000572100
—
FL
05
—
00976494
—
NY
05
—
821975428A
—
GA
Enumeration date
03/24/2006
Last updated
06/10/2009
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