Provider Demographics
NPI:1871560904
Name:ATIT, VIKRAM M (MD)
Entity type:Individual
Prefix:MR
First Name:VIKRAM
Middle Name:M
Last Name:ATIT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Mailing Address - Street 1:1011 US HWY 19
Mailing Address - Street 2:
Mailing Address - City:HOLIDAY
Mailing Address - State:FL
Mailing Address - Zip Code:34691
Mailing Address - Country:US
Mailing Address - Phone:727-937-4600
Mailing Address - Fax:727-937-3312
Practice Address - Street 1:1011 US HWY 19
Practice Address - Street 2:
Practice Address - City:HOLIDAY
Practice Address - State:FL
Practice Address - Zip Code:34691
Practice Address - Country:US
Practice Address - Phone:727-937-4600
Practice Address - Fax:727-937-3312
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00716342084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271853700Medicaid
FLG86849Medicare UPIN
FLAM861Medicare PIN