MEDICARE: JANANI SADASIVAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	2084N0400X	Neurology Physician	ME163507	FL

General Provider Information

NPI Number	:	1326609215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANANI SADASIVAN MD

Provider Business Mailing Address
First Line	:	2995 DREW ST FL 2
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33759-3012
Country	:	US
Telephone Number	:	727-315-7496
Fax Number	:

Provider Business Practice Location Address
First Line	:	2727 W DR MLK BLVD STE 700
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6378
Country	:	US
Telephone Number	:	813-321-1429
Fax Number	:	813-443-8117

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2019
Last Update Date	:	09/09/2024

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