SOUTHERN VASCULAR OF PANAMA CITY PLLC NPI 1699109181

NPI Information

  • NPI: 1699109181
  • Provider Name: SOUTHERN VASCULAR OF PANAMA CITY PLLC
  • Classification: Surgery - 2086S0129X
  • Specialization: Vascular Surgery
  • Entity Type: Organization
  • CLIA Number: 10D2202405
  • Address: 1399 JENKS AVE # 12
    PANAMA CITY, FL
    ZIP 32401
  • Phone: (850) 532-6303

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NPI Details

SOUTHERN VASCULAR OF PANAMA CITY PLLC is a vascular surgery surgery in Panama City, FL. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. SOUTHERN VASCULAR OF PANAMA CITY PLLC NPI is 1699109181. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1399 JENKS AVE # 12
PANAMA CITY, FL
ZIP 32401-442
Phone: (850) 532-6303
Fax: (850) 307-5402

The provider's authorized official is Ashish K Gupta .
The authorized official title is Physician/owner and has the following contact phone number (850) 896-1696.

The CLIA number assigned to this NPI record is 10D2202405 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/3/2013 and was last updated on 9/16/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12086S0129XSurgeryVascular SurgeryFLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1DU2333OTHERFLORIDARAILROAD MEDICARE
2004XTOTHERFLORIDAFLORIDA BLUE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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