Provider Demographics
NPI:1215279500
Name:VAKHARIA, PRIYA (MD)
Entity type:Individual
Prefix:
First Name:PRIYA
Middle Name:
Last Name:VAKHARIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PRIYA
Other - Middle Name:
Other - Last Name:SHARMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2705 W SAINT ISABEL ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6319
Mailing Address - Country:US
Mailing Address - Phone:813-879-5795
Mailing Address - Fax:813-877-4578
Practice Address - Street 1:3384 TAMPA RD
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3425
Practice Address - Country:US
Practice Address - Phone:727-333-9055
Practice Address - Fax:727-333-9045
Is Sole Proprietor?:No
Enumeration Date:2013-03-25
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME149143207WX0107X, 207W00000X
VA0101267064207W00000X, 207WX0107X
PAMT204882207W00000X
MDD0087716207WX0108X, 207WX0107X
MA269956207WX0108X
DCMD047139207WX0108X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0108XAllopathic & Osteopathic PhysiciansOphthalmologyUveitis and Ocular Inflammatory Disease
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC017238167Medicaid
VA1215279500Medicaid
FL111575900Medicaid