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General NPI Number Information
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NPI Number | 1972520310
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Entity Type | Individual
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Provider Name | VASUDHA VISWANATHAN MD
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Gender | Female
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 10/24/2019
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Provider Practice Location Address
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Address Line | 201 E SAMPLE RD
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City | DEERFIELD BEACH
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State | FL
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Zip | 33064-3502
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Country | US
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Telephone | 954-485-5666
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Fax | 954-484-1651
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Provider Business Mailing Address
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Address Line | 3601 W COMMERCIAL BLVD STE 5
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309-3392
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Country | US
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Telephone | 718-960-6551
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME87163
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 001983
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License Number State | NY
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