Basic Information
| Provider Information | |||||||||
| NPI: | 1396005153 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SUBHASH C. GUPTA, MD, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 601 E. SAMPLE ROAD | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | POMPANO BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33064 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543442522 | ||||||||
| FaxNumber: | 9543449189 | ||||||||
| Practice Location | |||||||||
| Address1: | 601 E SAMPLE RD | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | POMPANO BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33064 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9549431133 | ||||||||
| FaxNumber: | 9547836845 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2012 | ||||||||
| LastUpdateDate: | 05/25/2012 | ||||||||
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| AuthorizedOfficialLastName: | GUPTA | ||||||||
| AuthorizedOfficialFirstName: | SUBHASH | ||||||||
| AuthorizedOfficialMiddleName: | C | ||||||||
| AuthorizedOfficialTitleorPosition: | DOCTOR/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9547399000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | ME43566 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.