Healthcare Provider Details

I. General information

NPI: 1215279500
Provider Name (Legal Business Name): PRIYA VAKHARIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PRIYA SHARMA MD

II. Dates (important events)

Enumeration Date: 03/25/2013
Last Update Date: 11/11/2021
Certification Date: 11/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3384 TAMPA RD
PALM HARBOR FL
34684-3425
US

IV. Provider business mailing address

2705 W SAINT ISABEL ST
TAMPA FL
33607-6319
US

V. Phone/Fax

Practice location:
  • Phone: 727-333-9055
  • Fax: 727-333-9045
Mailing address:
  • Phone: 813-879-5795
  • Fax: 813-877-4578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberME149143
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME149143
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: