Provider Demographics
NPI:1053367847
Name:VIJAPURA, ASHIT K (MD)
Entity type:Individual
Prefix:MR
First Name:ASHIT
Middle Name:K
Last Name:VIJAPURA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 W DR MARTIN LUTHER KING JR BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-5105
Mailing Address - Country:US
Mailing Address - Phone:813-754-1496
Mailing Address - Fax:813-754-2553
Practice Address - Street 1:802 W DR MARTIN LUTHER KING JR BLVD STE D
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-5105
Practice Address - Country:US
Practice Address - Phone:813-754-1496
Practice Address - Fax:813-754-2553
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0050546174400000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL062139100Medicaid
FL09843Medicare ID - Type Unspecified
FLD41292Medicare UPIN