MEDICARE: DR. DEVANG M PADALIA MD

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	207LP2900X	Pain Medicine (Anesthesiology) Physician	ME93557	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	53018	OTHER	FL	BLUE CROSS BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346238748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEVANG M PADALIA MD

Provider Business Mailing Address
First Line	:	4509 N ARMENIA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33603-2703
Country	:	US
Telephone Number	:	813-873-7777
Fax Number	:	813-873-7776

Provider Business Practice Location Address
First Line	:	4509 N ARMENIA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33603-2703
Country	:	US
Telephone Number	:	813-873-7777
Fax Number	:	813-873-7776

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

Provider Enumeration Date	:	10/10/2005
Last Update Date	:	10/17/2023

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