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Individual

KIRAN K UPADHYAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1600 SW ARCHER RD, BOX 100296, GAINESVILLE, FL 32610-0296
(352) 265-7999
Mailing address
PO BOX 100296, GAINESVILLE, FL 32610-0296

Taxonomy

Speciality
Code
Description
License number
State
2080P0210X
Pediatric Nephrology Physician
263848
NY
2080P0210X
Pediatric Nephrology Physician
Primary
ME116049
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008874100
FL
05
201029000
IN
05
7100170360
KY
Enumeration date
05/12/2008
Last updated
09/26/2013
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