Healthcare Provider Details

I. General information

NPI: 1780662684
Provider Name (Legal Business Name): JOSEPH T M PLACHERIL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 03/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8623 54TH DRIVE EAST
BRADENTON FL
34202
US

IV. Provider business mailing address

8623 54TH DRIVE EAST
BRADENTON FL
34202
US

V. Phone/Fax

Practice location:
  • Phone: 941-758-1285
  • Fax: 941-739-6168
Mailing address:
  • Phone: 941-758-1285
  • Fax: 941-739-6168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME0071734
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: