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General NPI Number Information
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NPI Number | 1811183908
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Entity Type | Organization
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Legal Business Name | VATSALA SASTRY MD PA
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Dates
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Enumeration Date | 09/21/2007
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Last Update Date | 03/06/2012
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Provider Practice Location Address
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Address Line | 15435 CORTEZ BLVD
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City | BROOKSVILLE
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State | FL
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Zip | 34613-6113
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Country | US
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Telephone | 352-799-2294
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Fax |
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Provider Business Mailing Address
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Address Line | 15435 CORTEZ BLVD
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City | BROOKSVILLE
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State | FL
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Zip | 34613-6113
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Country | US
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Telephone | 352-799-2294
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Fax |
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | VATSALA SASTRY
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Credential | M.D.
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Telephone | 352-279-2183
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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