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General NPI Number Information
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NPI Number | 1558338202
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Entity Type | Individual
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Provider Name | DHVANIT K VIJAPURA M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/01/2006
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Last Update Date | 11/16/2020
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Provider Practice Location Address
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Address Line | 2003 WILSON AVE
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City | PANAMA CITY
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State | FL
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Zip | 32405-4532
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Country | US
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Telephone | 850-784-9991
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Fax | 850-763-8361
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Provider Business Mailing Address
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Address Line | 2003 WILSON AVE
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City | PANAMA CITY
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State | FL
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Zip | 32405-7612
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Country | US
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Telephone | 850-784-9991
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Fax | 850-763-8361
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME0059359
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License Number State | FL
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