Healthcare Provider Details

I. General information

NPI: 1336112945
Provider Name (Legal Business Name): PARVEEN SULTANA VAHORA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 09/21/2021
Certification Date: 09/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9332 STATE ROAD 54 SUITE 403
NEW PORT RICHEY FL
34655
US

IV. Provider business mailing address

9332 STATE ROAD 54 STE 403
NEW PORT RICHEY FL
34655-1810
US

V. Phone/Fax

Practice location:
  • Phone: 727-376-1536
  • Fax: 727-376-1539
Mailing address:
  • Phone: 727-376-1536
  • Fax: 727-376-1539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME91283
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberME91283
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: