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DR. AMBERPET YESURAJ RATHNAM MD NPI 1194802124


NPI Information

NPI: 1194802124
Provider Name: DR. AMBERPET YESURAJ RATHNAM, MD
Classification: Pediatrics - 2080A0000X
Entity Type: Individual

Specialization: Adolescent Medicine

PECOS Registration: Yes

CLIA Number: 33D0898505

Address:
6765 SUNSET STRIP
SUITE 6 & 7
SUNRISE, FL
ZIP 33313
Phone: (954) 572-7755
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DR. Amberpet Yesuraj Rathnam, MD is an adolescent medicine pediatrics in Sunrise, FL. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. DR. Amberpet Yesuraj Rathnam, MD NPI is 1194802124. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6765 SUNSET STRIP
SUITE 6 & 7
SUNRISE, FL
ZIP 33313-894
Phone: (954) 572-7755
Fax: (954) 572-7799

The NPI 1194802124 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The CLIA number assigned to this NPI record is 33D0898505 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/1/2006 and was last updated on 6/8/2022.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12080A0000XPediatricsAdolescent MedicineME90355FLORIDAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1271159100MEDICAIDFLORIDA

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.