Provider Demographics
NPI:1922237486
Name:DAS, DEVIKA GOVIND (MBBS)
Entity type:Individual
Prefix:
First Name:DEVIKA
Middle Name:GOVIND
Last Name:DAS
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100224
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0278
Mailing Address - Country:US
Mailing Address - Phone:522-737-8493
Mailing Address - Fax:
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-2110
Practice Address - Country:US
Practice Address - Phone:352-273-7832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL32229207RH0003X
FLME169982207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1114082088Medicaid
AL1114082088OtherGROUP NPI
AL511-66481OtherBCBS
AL5608245OtherUNITED HEALTHCARE
AL1021I15578Medicare UPIN