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General NPI Number Information
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NPI Number | 1699179283
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Entity Type | Organization
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Legal Business Name | HINA T GUPTA MD PA
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Dates
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Enumeration Date | 10/10/2014
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Last Update Date | 10/10/2014
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Provider Practice Location Address
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Address Line | 601 E SAMPLE RD STE 105
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City | POMPANO BEACH
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State | FL
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Zip | 33064-4443
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Country | US
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Telephone | 954-773-2383
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Fax | 954-783-6845
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Provider Business Mailing Address
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Address Line | 601 E SAMPLE RD STE 105
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City | POMPANO BEACH
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State | FL
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Zip | 33064-4443
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Country | US
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Telephone | 954-773-2383
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Fax | 954-783-6845
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Authorized Official
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Title or Position | OWNER
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Name | HINA T GUPTA
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Credential | MD
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Telephone | 319-621-8376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | ME113564
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License Number State | FL
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