Individual
DR. BRIJENDRA K GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2585 HERSCHEL ST, JACKSONVILLE, FL 32204-4557
(904) 388-2678
(904) 388-6776
Mailing address
2585 HERSCHEL ST, JACKSONVILLE, FL 32204-4557
(904) 388-2678
(904) 388-6776
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
ME93901
FL
207RN0300X
Nephrology Physician
Primary
ME93901
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273423100
—
FL
Enumeration date
02/23/2006
Last updated
06/29/2021
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