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General NPI Number Information
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NPI Number | 1245877547
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Entity Type | Organization
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Legal Business Name | VIJAPURA SPINE & SPORTS MEDICINE, PA
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Dates
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Enumeration Date | 12/05/2019
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Last Update Date | 12/05/2019
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Provider Practice Location Address
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Address Line | 9141 CYPRESS GREEN DR STE 1
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City | JACKSONVILLE
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State | FL
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Zip | 32256-2006
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Country | US
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Telephone | 904-400-3987
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Fax |
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Provider Business Mailing Address
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Address Line | 8236 CHESTER LAKE RD N
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City | JACKSONVILLE
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State | FL
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Zip | 32256-3402
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Country | US
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Telephone | 904-400-3987
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Fax |
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Authorized Official
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Title or Position | SPORTS MEDICINE
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Name | ANITA VIJAPURA
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Credential | MD
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Telephone | 904-400-3987
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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