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General NPI Number Information
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NPI Number | 1255337382
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Entity Type | Individual
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Provider Name | SUJAI DEEP NATH M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/23/2005
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Last Update Date | 05/24/2024
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Provider Practice Location Address
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Address Line | 800 MEADOWS RD
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City | BOCA RATON
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State | FL
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Zip | 33486-2304
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Country | US
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Telephone | 561-955-4600
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Fax | 833-625-1604
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Provider Business Mailing Address
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Address Line | 1001 NW 13TH ST STE 201
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City | BOCA RATON
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State | FL
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Zip | 33486-2269
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Country | US
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Telephone | 561-955-6663
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Fax | 561-955-2879
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 033253
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | DR-48179
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 33507
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | ME105307
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License Number State | FL
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