Healthcare Provider Details

I. General information

NPI: 1730174400
Provider Name (Legal Business Name): VINUBHAI C PANSURIYA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 09/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2180 9TH AVE N
ST PETERSBURG FL
33713
US

IV. Provider business mailing address

P O BOX 7505 VINUBHAI PANSURIYA
ST PETERSBURG FL
33734-7505
US

V. Phone/Fax

Practice location:
  • Phone: 727-522-3600
  • Fax:
Mailing address:
  • Phone: 727-522-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD419228
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME98202
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberME98202
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME98202
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberME98202
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: