Provider Demographics
NPI:1871541094
Name:SEKHON, GURPRIT (MD)
Entity type:Individual
Prefix:
First Name:GURPRIT
Middle Name:
Last Name:SEKHON
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 1:10800 PANAMA CITY BEACH PARKWAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PANAMA CITY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32407-2607
Mailing Address - Country:US
Mailing Address - Phone:850-249-6363
Mailing Address - Fax:850-249-6680
Practice Address - Street 1:10800 PANAMA CITY BEACH PARKWAY
Practice Address - Street 2:SUITE 200
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32407-2607
Practice Address - Country:US
Practice Address - Phone:850-249-6363
Practice Address - Fax:850-249-6680
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 83912207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL263126101Medicaid
H55164Medicare UPIN
FLP00324257Medicare PIN
FL263126101Medicaid