Individual
VIVEK GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2109 60TH ST W, BRADENTON, FL 34209-5526
(941) 315-1919
Mailing address
6610 TURNSTONE LN, LAKEWOOD RANCH, FL 34202-8291
(941) 315-1919
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
Primary
ME94215
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002542500
—
FL
Enumeration date
06/15/2006
Last updated
01/25/2011
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