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NPI Code Detail

MEDICARE: FERNANDO MANUEL PELLERANO SOSA MD

MEDICARE: FERNANDO MANUEL PELLERANO SOSA 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
1390200000XStudent in an Organized Health Care Education/Training Program
2207W00000XOphthalmology Physician01097961AIN

General Provider Information

NPI Number : 1982229555
Entity Type Code : Individual
Provider Name (Legal Business Name) : FERNANDO MANUEL PELLERANO SOSA MD
Provider Business Mailing Address
First Line : 250 N SHADELAND AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46219-4959
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10300 N ILLINOIS ST
Second Line :
City : CARMEL
State : IN
Zip : 46290-1166
Country : US
Telephone Number : 317-817-8080
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2020
Last Update Date : 04/17/2026

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Directions to “ FERNANDO MANUEL PELLERANO SOSA MD” Practice Location

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