Provider Demographics
NPI:1174150379
Name:GUPTA, PRIYA (DO)
Entity type:Individual
Prefix:DR
First Name:PRIYA
Middle Name:
Last Name:GUPTA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5540 E GRANT ST STE A
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-1668
Mailing Address - Country:US
Mailing Address - Phone:407-367-4706
Mailing Address - Fax:321-203-4606
Practice Address - Street 1:5540 E GRANT ST STE A
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-1668
Practice Address - Country:US
Practice Address - Phone:407-367-4706
Practice Address - Fax:321-203-4606
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY323039207R00000X
FLOS22150207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine