Provider Demographics
NPI:1154436889
Name:GUPTA, VIRIND D (MD)
Entity type:Individual
Prefix:DR
First Name:VIRIND
Middle Name:D
Last Name:GUPTA
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 1:4541 BEE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-2517
Mailing Address - Country:US
Mailing Address - Phone:941-371-9355
Mailing Address - Fax:941-379-8825
Practice Address - Street 1:4541 BEE RIDGE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-2517
Practice Address - Country:US
Practice Address - Phone:941-371-9355
Practice Address - Fax:941-379-8825
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0057638207QS0010X, 207QS1201X, 208D00000X, 208VP0000X, 207Q00000X, 207QA0000X, 207QA0401X, 207QA0505X, 207QB0002X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207QS1201XAllopathic & Osteopathic PhysiciansFamily MedicineSleep Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL064280100Medicaid
FLA54932Medicare UPIN
FL11316CMedicare ID - Type Unspecified