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NPI Code Detail

MEDICARE: GAURAV A. BANSODE MD

MEDICARE: GAURAV A. BANSODE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianME158614FL
2207Q00000XFamily Medicine Physician12665ND

General Provider Information

NPI Number : 1134433857
Entity Type Code : Individual
Provider Name (Legal Business Name) : GAURAV A. BANSODE MD
Provider Business Mailing Address
First Line : 400 N TAMPA ST FL 15
Second Line :
City : TAMPA
State : FL
Zip : 33602-4730
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 400 N TAMPA ST FL 15
Second Line :
City : TAMPA
State : FL
Zip : 33602-4730
Country : US
Telephone Number : 888-803-3370
Fax Number : 888-803-3331
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2010
Last Update Date : 06/01/2026

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Directions to “ GAURAV A. BANSODE MD” Practice Location

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