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General NPI Number Information
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NPI Number | 1447403340
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Entity Type | Individual
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Provider Name | MEERA SURUJDAI BEHARRY M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/23/2008
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Last Update Date | 07/29/2021
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Provider Practice Location Address
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Address Line | 16 HARBOUR ISLE DR W UNIT PH01
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City | FORT PIERCE
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State | FL
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Zip | 34949-2768
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Country | US
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Telephone | 254-718-7559
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4455
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City | FORT PIERCE
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State | FL
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Zip | 34948-4455
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Country | US
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Telephone | 254-718-7559
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Fax |
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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 | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 228681
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | P4286
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | ME147988
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License Number State | FL
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