Healthcare Provider Details

I. General information

NPI: 1659580066
Provider Name (Legal Business Name): HINA T GUPTA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HINA H TRIPATHI MD

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 09/21/2022
Certification Date: 09/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4515 WILES RD STE 201
COCONUT CREEK FL
33073-3414
US

IV. Provider business mailing address

15280 NW 79TH CT STE 200
MIAMI LAKES FL
33016-5873
US

V. Phone/Fax

Practice location:
  • Phone: 954-943-1418
  • Fax: 786-662-3670
Mailing address:
  • Phone: 305-558-3724
  • Fax: 786-907-7485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberME113564
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: