Individual
AMIT G GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 W MORENO ST, PENSACOLA, FL 32501-2316
(850) 436-4951
(850) 438-6767
Mailing address
PO BOX 622047, ORLANDO, FL 32862-2047
(850) 436-4951
(850) 438-6767
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
ME73273
FL
2085N0904X
Nuclear Radiology Physician
ME73273
FL
2085P0229X
Pediatric Radiology Physician
ME73273
FL
2085R0202X
Diagnostic Radiology Physician
Primary
ME73273
FL
2085R0204X
Vascular & Interventional Radiology Physician
ME73273
FL
2085U0001X
Diagnostic Ultrasound Physician
ME73273
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41554
BCBS
FL
01
—
51033890GUP
BCBS
AL
Enumeration date
07/31/2006
Last updated
07/11/2007
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