Provider Demographics
NPI:1801109780
Name:PARYANI, NITESH N (MD)
Entity type:Individual
Prefix:
First Name:NITESH
Middle Name:N
Last Name:PARYANI
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 1:405 S DALE MABRY HWY # 362
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-2820
Mailing Address - Country:US
Mailing Address - Phone:904-219-7660
Mailing Address - Fax:607-324-7615
Practice Address - Street 1:3001 W DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6307
Practice Address - Country:US
Practice Address - Phone:813-870-4160
Practice Address - Fax:813-870-4693
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1106022085R0001X
KS04-398182085R0001X
MO20170083412085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIE944VMedicare PIN
FLIE944YMedicare PIN
FLIE944WMedicare PIN
FLIE944XMedicare PIN
FL1120662OtherCAREPLUS
FL150JBOtherBCBS FL
FLIE944WMedicare PIN
FL1193444OtherWELLCARE
FLP01514615OtherRAILROAD MEDICARE
FLIE944XMedicare PIN
FL384355OtherAVMED
FL015376800Medicaid
FL150JBOtherBCBS