Provider Demographics
NPI:1427089309
Name:MEHTA, VIKRAM P (MD)
Entity type:Individual
Prefix:DR
First Name:VIKRAM
Middle Name:P
Last Name:MEHTA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4106 W. LAKE MARY BLVD
Mailing Address - Street 2:SUITE 224
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746
Mailing Address - Country:US
Mailing Address - Phone:407-333-4548
Mailing Address - Fax:407-333-1797
Practice Address - Street 1:4106 W. LAKE MARY BLVD
Practice Address - Street 2:SUITE 224
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746
Practice Address - Country:US
Practice Address - Phone:407-333-4548
Practice Address - Fax:407-333-1797
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00556122086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1427089309OtherNPI NUMBER
E15509Medicare UPIN
FL064449800Medicaid