MEDICARE: DHVANIT K VIJAPURA 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
1	2084P0800X	Psychiatry Physician	ME59359	FL

General Provider Information

NPI Number	:	1669565974
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DHVANIT K VIJAPURA MD

Provider Business Mailing 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

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	:	PRACTICE ADM
Name	:	AMY N STREICHERT
Credential	:
Telephone Number	:	850-784-9991

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	12/02/2020

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