MEDICARE: DR. DHVANIT K VIJAPURA M.D.

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
1	2084P0800X	Psychiatry Physician	ME0059359	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	12482	OTHER	FL	BCBS FLORIDA

General Provider Information

NPI Number	:	1558338202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DHVANIT K VIJAPURA M.D.

Provider Business Mailing Address
First Line	:	2003 WILSON AVE
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-7612
Country	:	US
Telephone Number	:	850-784-9991
Fax Number	:	850-763-8361

Provider Business Practice Location Address
First Line	:	2003 WILSON AVE
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4532
Country	:	US
Telephone Number	:	850-784-9991
Fax Number	:	850-763-8361

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2006
Last Update Date	:	11/16/2020

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