SUBHASH C. GUPTA, MD, PA
Osteopathic Medicine at Sample Rd, Pompano Beach, FL

License number
Florida ME43566
Category
Osteopathic Medicine
Type
Gastroenterology
Owner
Name: SUBHASH C GUPTA MD
Title: DOCTOR/OWNER
Phone: (954) 739-9000
Address
Address
601 E Sample Rd SUITE 105, Pompano Beach, FL 33064
National Provider ID: 1396005153
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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SUBHASH C. GUPTA, M.D., PA

601 E Sample Rd SUITE 105, Pompano Beach, FL 33064

Status:
Inactive
Inactive reason:
REINSTATEMENT
Registration:
Jul 25, 1986
Inactive since:
May 15, 2015
State ID:
J26445
Business type:
Florida Profit Corporation
President, Director, Secretary:
Subhash Cmd Gupta President, Director, Secretary, inactive, 601 E Sample Rd SUITE 105, Pompano Beach, FL 33064 (Physical)
Agent:
Subhash Gupta,601 E Sample Rd, Pompano Beach, FL 33064 (Physical)
EIN:
59-2726440

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