MEDICARE: MR. ASHIT K VIJAPURA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	ME0050546	FL
2	2084P0800X	Psychiatry Physician	ME0050546	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053367847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ASHIT K VIJAPURA M.D.

Provider Business Mailing Address
First Line	:	802 W DR MARTIN LUTHER KING JR BLVD STE D
Second Line	:
City	:	PLANT CITY
State	:	FL
Zip	:	33563-5105
Country	:	US
Telephone Number	:	813-754-1496
Fax Number	:	813-754-2553

Provider Business Practice Location Address
First Line	:	802 W DR MARTIN LUTHER KING JR BLVD STE D
Second Line	:
City	:	PLANT CITY
State	:	FL
Zip	:	33563-5105
Country	:	US
Telephone Number	:	813-754-1496
Fax Number	:	813-754-2553

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	12/01/2022

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