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General NPI Number Information
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NPI Number | 1518946888
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Entity Type | Individual
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Provider Name | ANAND S GUPTA MD
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Gender | Male
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Dates
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Enumeration Date | 01/13/2006
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Last Update Date | 07/10/2020
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Provider Practice Location Address
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Address Line | 2535 UNIVERSITY BLVD W
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City | JACKSONVILLE
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State | FL
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Zip | 32217-2003
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Country | US
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Telephone | 904-367-8686
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Fax | 904-367-0211
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Provider Business Mailing Address
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Address Line | 2535 UNIVERSITY BLVD W
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City | JACKSONVILLE
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State | FL
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Zip | 32217-2003
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Country | US
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Telephone | 904-874-8282
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Fax | 904-367-0211
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME067766
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME67766
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License Number State | FL
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