Healthcare Provider Details
I. General information
NPI: 1851558043
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
10817 BLOOMINGDALE AVE
RIVERVIEW FL
33578-3616
US
IV. Provider business mailing address
3003 W MARTIN LUTHER KING BLVD MS 3012
TAMPA FL
33607
US
V. Phone/Fax
- Phone: 813-870-4438
- Fax:
- Phone: 813-870-4438
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0206X |
| Taxonomy | Pediatric 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