Basic Information
| Provider Information | |||||||||
| NPI: | 1386816379 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ASOPA | ||||||||
| FirstName: | AMIT | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD,FRCA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 9033 | ||||||||
| Address2: | |||||||||
| City: | STUART | ||||||||
| State: | FL | ||||||||
| PostalCode: | 349959033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7722232832 | ||||||||
| FaxNumber: | 7722235646 | ||||||||
| Practice Location | |||||||||
| Address1: | 509 SE RIVERSIDE DR STE 203 | ||||||||
| Address2: | |||||||||
| City: | STUART | ||||||||
| State: | FL | ||||||||
| PostalCode: | 349942579 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7722885862 | ||||||||
| FaxNumber: | 7722885874 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2008 | ||||||||
| LastUpdateDate: | 04/13/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 246983 | MA | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | 45130 | KY | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207LP2900X | ME132163 | FL | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | YH38Q | 01 | FL | FLORIDA BLUE | OTHER | 022432100 | 05 | FL | MEDICAID |