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NPI Code Detail

MEDICARE: DR. HEMANT P GUNDAVDA M.D.

MEDICARE: DR. HEMANT P GUNDAVDA 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
1208000000XPediatrics PhysicianME127710FL

Other Identifiers

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

General Provider Information

NPI Number : 1053386284
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HEMANT P GUNDAVDA M.D.
Provider Business Mailing Address
First Line : 1545 9TH ST SW
Second Line :
City : VERO BEACH
State : FL
Zip : 32962-4312
Country : US
Telephone Number : 772-257-8224
Fax Number : 772-213-3157
Provider Business Practice Location Address
First Line : 1545 9TH ST SW
Second Line :
City : VERO BEACH
State : FL
Zip : 32962-4312
Country : US
Telephone Number : 772-257-8224
Fax Number : 772-213-3157
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2006
Last Update Date : 02/20/2018

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