Healthcare Provider Details

I. General information

NPI: 1891809281
Provider Name (Legal Business Name): ASHA K GUPTA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9663 WESTVIEW DR
CORAL SPRINGS FL
33076-2513
US

IV. Provider business mailing address

1608 SE 3RD AVE FL 3
FORT LAUDERDALE FL
33316-2564
US

V. Phone/Fax

Practice location:
  • Phone: 954-320-3323
  • Fax: 954-753-6377
Mailing address:
  • Phone: 954-320-3323
  • Fax: 954-753-6377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberME61061
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: