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NPI Code Detail

MEDICARE: DR. SUTANU MISRA MD

MEDICARE: DR. SUTANU MISRA 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
1207L00000XAnesthesiology PhysicianME126867FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598765422
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUTANU MISRA MD
Provider Business Mailing Address
First Line : 4444 ARABIAN WAY
Second Line :
City : COOPER CITY
State : FL
Zip : 33328-2802
Country : US
Telephone Number : 724-831-9042
Fax Number :
Provider Business Practice Location Address
First Line : 8201 W BROWARD BLVD
Second Line :
City : PLANTATION
State : FL
Zip : 33324-2701
Country : US
Telephone Number : 954-473-6600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2005
Last Update Date : 02/05/2020

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Directions to “ DR. SUTANU MISRA MD” Practice Location

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