Healthcare Provider Details

I. General information

NPI: 1295139699
Provider Name (Legal Business Name): UPMA SUNEJA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2014
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 W GORE ST
ORLANDO FL
32806-1141
US

IV. Provider business mailing address

PO BOX 917770
ORLANDO FL
32891-0001
US

V. Phone/Fax

Practice location:
  • Phone: 347-433-0059
  • Fax:
Mailing address:
  • Phone: 813-974-2201
  • Fax: 813-974-4325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME137883
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: