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NPI Code Detail

MEDICARE: DR. DEEPAK KUMAR PASUPULA MD, MPH

MEDICARE: DR. DEEPAK KUMAR PASUPULA MD, MPH
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
1207RC0001XClinical Cardiac Electrophysiology PhysicianME160409FL
2207RC0000XCardiovascular Disease PhysicianME160409FL

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 : 1619382397
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEEPAK KUMAR PASUPULA MD, MPH
Provider Business Mailing Address
First Line : PO BOX 551308
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32255-1308
Country : US
Telephone Number : 904-493-3333
Fax Number : 904-493-2222
Provider Business Practice Location Address
First Line : 7011 A C SKINNER PKWY STE 160
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-6953
Country : US
Telephone Number : 904-493-3333
Fax Number : 904-493-2222
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2014
Last Update Date : 05/15/2026

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