Provider Demographics
NPI:1154517068
Name:ASHIT K VIJAPURA MD PA
Entity type:Organization
Organization Name:ASHIT K VIJAPURA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHIT
Authorized Official - Middle Name:K
Authorized Official - Last Name:VIJAPURA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-754-1496
Mailing Address - Street 1:802 W DR MARTIN LUTHER KING JR BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-5105
Mailing Address - Country:US
Mailing Address - Phone:813-754-1496
Mailing Address - Fax:813-754-2553
Practice Address - Street 1:802 W DR MARTIN LUTHER KING JR BLVD STE D
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-5105
Practice Address - Country:US
Practice Address - Phone:813-754-1496
Practice Address - Fax:813-754-2553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL09843OtherBLUE CROSS BLUE SHIELD
FL116036500Medicaid
FL33160Medicare PIN
FL09843OtherBLUE CROSS BLUE SHIELD