Organization
SUNIL GUPTA MD LLC
Active
Other names
Retina Specialty Institute
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUNIL GUPTA M.D. (MANAGING MEMBER)
(850) 476-6759
Entity
Organization
Contact information
Practice address
5150 N DAVIS HWY, PENSACOLA, FL 32503-2030
(850) 476-6759
(850) 484-5222
Mailing address
5150 N DAVIS HWY, PENSACOLA, FL 32503-2030
(850) 476-6759
(850) 484-5222
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME66379
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07331062
MEDICAID
MS
05
—
09016091
—
MS
05
—
267921300
—
FL
01
—
34843
BLUE CROSS PROVIDER GROUP
FL
05
—
529917080
—
AL
Enumeration date
05/26/2006
Last updated
08/31/2011
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