Healthcare Provider Details

I. General information

NPI: 1093972127
Provider Name (Legal Business Name): THIRU S. ARASU, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2008
Last Update Date: 06/20/2023
Certification Date: 06/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14111 STATE ROAD 54
ODESSA FL
33556-3663
US

IV. Provider business mailing address

3003 W. MARTIN LUTHER KING BLVD MS 3012
TAMPA FL
33607
US

V. Phone/Fax

Practice location:
  • Phone: 813-870-4438
  • Fax:
Mailing address:
  • Phone: 813-870-4438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. THIRU S ARASU
Title or Position: PRESIDENT
Credential: M.D.
Phone: 813-870-4438