Provider Demographics
NPI:1487714481
Name:GEDIA, LAKHABHAI D (MD)
Entity type:Individual
Prefix:
First Name:LAKHABHAI
Middle Name:D
Last Name:GEDIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 S PARSONS AVE
Mailing Address - Street 2:
Mailing Address - City:SEFFNER
Mailing Address - State:FL
Mailing Address - Zip Code:33584-5212
Mailing Address - Country:US
Mailing Address - Phone:813-684-3222
Mailing Address - Fax:813-681-8942
Practice Address - Street 1:2204 S PARSONS AVE
Practice Address - Street 2:
Practice Address - City:SEFFNER
Practice Address - State:FL
Practice Address - Zip Code:33584-5212
Practice Address - Country:US
Practice Address - Phone:813-684-3222
Practice Address - Fax:813-681-8942
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME45500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL96908OtherBCBS PROVIDER NUMBER
FL046478300Medicaid
FLD77130Medicare UPIN
FL96908YMedicare PIN