Healthcare Provider Details

I. General information

NPI: 1184083248
Provider Name (Legal Business Name): DR. SARIKA GUPTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2016
Last Update Date: 02/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 N ORANGE AVE 701
ORLANDO FL
32804-4603
US

IV. Provider business mailing address

2650 DADE AVE # NO1306
ORLANDO FL
32804-4607
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-5800
  • Fax:
Mailing address:
  • Phone: 407-910-5981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number22366
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: