Individual
DR. GOURI RAVIN PIMPUTKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
100 N EDINBURGH DR, WINTER PARK, FL 32792-4125
(407) 645-5565
(407) 647-1135
Mailing address
PO BOX 25317, TAMPA, FL 33622-5317
(813) 286-0033
(813) 282-1806
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
GP014942
MI
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
OS16869
FL
207VX0000X
Obstetrics Physician
Primary
OS16869
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114809581
—
MI
01
—
BLUE CROSS
1656314165
MI
Enumeration date
08/10/2006
Last updated
08/20/2021
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