Provider Demographics
NPI:1306050232
Name:VYAS, PRIYANKA (MD)
Entity type:Individual
Prefix:DR
First Name:PRIYANKA
Middle Name:
Last Name:VYAS
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 1:6910 NW 52ND LN
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32653-3954
Mailing Address - Country:US
Mailing Address - Phone:352-559-8911
Mailing Address - Fax:352-559-8877
Practice Address - Street 1:100 SW 75TH ST STE 101
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-5775
Practice Address - Country:US
Practice Address - Phone:352-559-8911
Practice Address - Fax:352-559-8877
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME116979208000000X
ARE-6560208000000X
TXP3831208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010376700Medicaid
AR185076001Medicaid
AR5AE70Medicare PIN