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NPI Code Detail

MEDICARE: DR. JAMUNA SIVAKANTHAN M.D.

MEDICARE: DR. JAMUNA SIVAKANTHAN M.D.
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
1208100000XPhysical Medicine & Rehabilitation Physician062181LPA
2208100000XPhysical Medicine & Rehabilitation PhysicianME108680FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1780359OTHERPAMEDICARE PROVIDER

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346242492
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMUNA SIVAKANTHAN M.D.
Provider Business Mailing Address
First Line : PO BOX 947407
Second Line :
City : ATLANTA
State : GA
Zip : 30394-7407
Country : US
Telephone Number : 941-917-2600
Fax Number : 941-917-7884
Provider Business Practice Location Address
First Line : 1700 S TAMIAMI TRL
Second Line :
City : SARASOTA
State : FL
Zip : 34239-3509
Country : US
Telephone Number : 941-917-8561
Fax Number : 941-917-2675
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 09/19/2022

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