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MANJUL DERASARI M.D.P.A. NPI 1407915929


NPI Information

NPI: 1407915929
Provider Name: MANJUL DERASARI M.D.,P.A.
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1912 E BUSCH BLVD
TAMPA, FL
ZIP 33612
Phone: (813) 933-5900
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MANJUL DERASARI M.D.,P.A. is a specialist in Tampa, FL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MANJUL DERASARI M.D.,P.A. NPI is 1407915929. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1912 E BUSCH BLVD
TAMPA, FL
ZIP 33612-666
Phone: (813) 933-5900
Fax: (813) 935-9687

The provider's authorized official is Manjul D Derasari .
The authorized official title is Medical Director and has the following contact phone number (813) 933-5900.

The enumeration date for this NPI number is 12/8/2006 and was last updated on 12/19/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistME54111FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1050088184MEDICARE ID-TYPE UNSPECIFIEDFLORIDAMEDICARE RAILROAD
22720607OTHERFLORIDAAETNA
3064751900MEDICAIDFLORIDA
411609OTHERFLORIDABC BS
5E68773MEDICARE UPINFLORIDA
611609SMEDICARE ID-TYPE UNSPECIFIEDFLORIDAMEDICARE INDIVIDUAL
7K3314MEDICARE ID-TYPE UNSPECIFIEDFLORIDAMEDICARE GROUP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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