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General NPI Number Information
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NPI Number | 1578574984
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Entity Type | Individual
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Provider Name | GOURI RAVIN PIMPUTKAR D.O.
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Gender | Female
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 08/20/2021
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Provider Practice Location Address
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Address Line | 100 N EDINBURGH DR
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City | WINTER PARK
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State | FL
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Zip | 32792-4125
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Country | US
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Telephone | 407-645-5565
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Fax | 407-647-1135
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Provider Business Mailing Address
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Address Line | PO BOX 25317
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City | TAMPA
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State | FL
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Zip | 33622-5317
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Country | US
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Telephone | 813-286-0033
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Fax | 813-282-1806
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | GP014942
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | OS16869
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | OS16869
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License Number State | FL
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