Healthcare Provider Details

I. General information

NPI: 1669794004
Provider Name (Legal Business Name): RINKI G VERMA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2010
Last Update Date: 08/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 TOWN CENTER DR SUITE 200
ORANGE CITY FL
32763-8255
US

IV. Provider business mailing address

955 TOWN CENTER DR SUITE 200
ORANGE CITY FL
32763-8255
US

V. Phone/Fax

Practice location:
  • Phone: 386-775-1612
  • Fax: 386-775-1289
Mailing address:
  • Phone: 386-775-1612
  • Fax: 386-775-1289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberME77908
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: