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General NPI Number Information
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NPI Number | 1669565974
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Entity Type | Organization
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Legal Business Name | DHVANIT K VIJAPURA MD
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 12/02/2020
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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 | 32405-4532
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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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Authorized Official
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Title or Position | PRACTICE ADM
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Name | AMY N STREICHERT
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Credential |
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Telephone | 850-784-9991
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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 | ME59359
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License Number State | FL
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