Healthcare Provider Details

I. General information

NPI: 1437839503
Provider Name (Legal Business Name): SATHISH KOTTAISAMY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST
LEXINGTON KY
40536-3498
US

IV. Provider business mailing address

9175 SOLSTICE CIR
PARKLAND FL
33076-2672
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-5956
  • Fax: 859-323-1080
Mailing address:
  • Phone: 786-438-8213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License NumberFL082
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: