Provider Demographics
NPI:1285699777
Name:GHOSH, PARAMITA (MD)
Entity type:Individual
Prefix:DR
First Name:PARAMITA
Middle Name:
Last Name:GHOSH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17325 PAGONIA RD
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-6008
Mailing Address - Country:US
Mailing Address - Phone:407-905-6005
Mailing Address - Fax:407-654-7536
Practice Address - Street 1:17325 PAGONIA RD
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-6008
Practice Address - Country:US
Practice Address - Phone:407-905-6005
Practice Address - Fax:407-654-7536
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95202207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
06269070OtherECFMG
FLP00671496Medicare PIN
FLU8831ZMedicare PIN
FLCB3518Medicare PIN
FLI65900Medicare UPIN
06269070OtherECFMG