Healthcare Provider Details

I. General information

NPI: 1801109780
Provider Name (Legal Business Name): NITESH N PARYANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2010
Last Update Date: 05/07/2021
Certification Date: 05/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 W DR MARTIN LUTHER KING JR BLVD
TAMPA FL
33607-6307
US

IV. Provider business mailing address

405 S DALE MABRY HWY # 362
TAMPA FL
33609-2820
US

V. Phone/Fax

Practice location:
  • Phone: 813-870-4160
  • Fax: 813-870-4693
Mailing address:
  • Phone: 904-219-7660
  • Fax: 607-324-7615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberME110602
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number04-39818
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number2017008341
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: