Healthcare Provider Details

I. General information

NPI: 1801902283
Provider Name (Legal Business Name): PIYUSH KANUBHAI DALAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1266 TURNER ST
CLEARWATER FL
33756-5921
US

IV. Provider business mailing address

1266 TURNER ST
CLEARWATER FL
33756-5921
US

V. Phone/Fax

Practice location:
  • Phone: 727-446-0176
  • Fax: 727-446-4906
Mailing address:
  • Phone: 727-446-0176
  • Fax: 727-446-4906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME0069799
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: