Healthcare Provider Details

I. General information

NPI: 1003015892
Provider Name (Legal Business Name): THIRUPPATHY R. SABAPATHY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2007
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1890 SUMMIT BLVD STE 210
PENSACOLA FL
32503-3357
US

IV. Provider business mailing address

5342 CLARK RD # 41671
SARASOTA FL
34233-3227
US

V. Phone/Fax

Practice location:
  • Phone: 850-549-9060
  • Fax:
Mailing address:
  • Phone: 773-885-1666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number036114409
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number036114409
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberOS20373
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: