Provider Demographics
NPI:1730174400
Name:PANSURIYA, VINUBHAI C (MD)
Entity type:Individual
Prefix:DR
First Name:VINUBHAI
Middle Name:C
Last Name:PANSURIYA
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:P O BOX 7505
Mailing Address - Street 2:VINUBHAI PANSURIYA
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33734-7505
Mailing Address - Country:US
Mailing Address - Phone:727-522-3600
Mailing Address - Fax:
Practice Address - Street 1:2180 9TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713
Practice Address - Country:US
Practice Address - Phone:727-522-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD419228207R00000X
FLME98202207R00000X, 207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA815402OtherFIRST PRIORITY HEALTH
PA001449429OtherBLUE SHIELD
PA001924982Medicaid
PA063093Medicare ID - Type Unspecified
PA001924982Medicaid
PA815402OtherFIRST PRIORITY HEALTH