MEDICARE: DR. SAGAR AMIT 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	ME128924	FL
2	2084P0800X	Psychiatry Physician	Q5596	TX

General Provider Information

NPI Number	:	1710253885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAGAR AMIT VIJAPURA M.D.

Provider Business Mailing Address
First Line	:	9141 CYPRESS GREEN DR STE 1
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-2006
Country	:	US
Telephone Number	:	904-733-7333
Fax Number	:	904-404-8342

Provider Business Practice Location Address
First Line	:	9141 CYPRESS GREEN DR STE 1
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-2006
Country	:	US
Telephone Number	:	904-733-7333
Fax Number	:	904-404-8342

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

Provider Enumeration Date	:	03/22/2012
Last Update Date	:	07/21/2022

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