Healthcare Provider Details
I. General information
NPI: 1497727382
Provider Name (Legal Business Name): SATISH VENKATAPERUMAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/03/2006
Last Update Date: 04/03/2024
Certification Date: 04/03/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4219 US HIGHWAY 19
NEW PORT RICHEY FL
34652-5906
US
IV. Provider business mailing address
5365 W ATLANTIC AVE SUITE 504
DELRAY BEACH FL
33484-8172
US
V. Phone/Fax
- Phone: 727-939-2230
- Fax: 727-847-5349
- Phone: 561-241-9300
- Fax: 561-241-9339
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208VP0014X |
| Taxonomy | Interventional Pain Medicine Physician |
| License Number | ME80382 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | ME 80382 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208VP0000X |
| Taxonomy | Pain Medicine Physician |
| License Number | ME80382 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: