MEDICARE: INDU SENAPATI 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
1	2084P0800X	Psychiatry Physician	MD0000033830	TN
2	174400000X	Specialist	ME110947	FL
3	2084P0800X	Psychiatry Physician	ME110947	FL

General Provider Information

NPI Number	:	1659428944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	INDU SENAPATI M.D.

Provider Business Mailing Address
First Line	:	4740 N STATE ROAD 7 STE 201
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33319-5839
Country	:	US
Telephone Number	:	954-777-1617
Fax Number	:	954-497-3857

Provider Business Practice Location Address
First Line	:	4720 N STATE ROAD 7 BLDG B
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33319-5860
Country	:	US
Telephone Number	:	954-777-1617
Fax Number	:	954-497-3857

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

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	12/13/2013

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