ADITYA MANJUL DERASARI (NPI# 1902070725) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902070725 |
| Entity Type | Individual |
| Full Name | ADITYA MANJUL DERASARI |
| Credential | M.D. |
| Practice Address |
1611 Nw 12th Ave Miami FL 33136-1005 |
| Mailing Address |
Po Box 16960 Miami FL 33101-6960 |
| Practice Telephone | 3052433000 |
| Mailing Telephone | 3012433000 |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2019-03-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0114X |
Orthopaedic Surgery Specialization: Adult Reconstructive Orthopaedic Surgery |
276427 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
1611 NW 12TH AVE |
| City | MIAMI |
| State | FL |
| Zip Code | 33136-1005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740286251 | Karen Chitty | Emergency Medicine | 1611 Nw 12th Ave, Miami, FL 33136-1005 | 2005-06-21 |
| 1558968263 | Natalie Dinger | Nurse Practitioner | 1611 Nw 12th Ave, Miami, FL 33136-1096 | 2020-10-06 |
| 1306452057 | Ryan M Bukhari | Dentist | 1611 Nw 12th Ave, Miami, FL 33136-1096 | 2020-09-18 |
| 1467068155 | Hussien Touny | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Ave, Miami, FL 33136-1096 | 2020-09-18 |
| 1912512310 | Clementina Aurora Cabrera | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Ave, Miami, FL 33136-1005 | 2020-09-11 |
| 1184237265 | Kencya Toussaint | Nurse Practitioner | 1611 Nw 12th Ave, Miami, FL 33136-1096 | 2020-08-28 |
| 1568075976 | Manuel Molina | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Ave, Miami, FL 33136-1005 | 2020-08-25 |
| 1063025468 | Carlos Federico Moral Ortega | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Ave, Miami, FL 33136-1096 | 2020-08-25 |
| 1770195919 | Ezekiel Oluwasayo Ijaopo | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Ave, Miami, FL 33136-1005 | 2020-08-19 |
| 1568070258 | Virosh Dharmadasa | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Ave, Miami, FL 33136-1005 | 2020-07-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548875685 | Agustina Dirocco | Registered Nurse | 1611 Ne 12th Ave, Miami, FL 33136 | 2020-09-15 |
| 1093338451 | Krizia Amy Vinck | Clinical Neuropsychologist | 1150 Nw 14th St, Miami, Fl 33136, Miami, FL 33136 | 2020-05-20 |
| 1992327761 | Jorge Luis Cardenas Alvarez | Student in an Organized Health Care Education/Training Program | 1611 Nw 12 Avenue Central Room 600-d, Miami, FL 33136 | 2020-05-14 |
| 1104447036 | Denver Steven Pinto | Student in an Organized Health Care Education/Training Program | 1611 Nw 12 Avenue Jackson Memorial Hospital, West Wing 279 Emergency Radiology, Miami, FL 33136 | 2020-05-01 |
| 1992325724 | Dimple Kumar Chanamolu | Student in an Organized Health Care Education/Training Program | Deptarment of Urology University of Miama Miller School, Crb 1120 Nw 14th Street Suite 1551c, Miami, FL 33136 | 2020-04-22 |
| 1578100996 | Alex Aziz Al Khoury | Internal Medicine | 1120 Nw 14th St. Suite 1112, Miami, FL 33136 | 2019-12-04 |
| 1437708872 | Marie Jeanjean | Genetic Counselor, MS | 1501 Nw 10th Avenue, Brb 334 (m860), Miami, FL 33136 | 2019-09-09 |
| 1710543905 | Tal Friehmann | Student in an Organized Health Care Education/Training Program | Jackson Memorial Hospital, Breast Imaging Dep, 1611 Nw 12 Avenue, Miami, FL 33136 | 2019-05-14 |
| 1285297895 | Omar Munoz | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Av., Psychiatry Department, Miami, FL 33136 | 2019-04-18 |
| 1902369648 | Seyedeh Haleh Amirian | Student in an Organized Health Care Education/Training Program | 1611 12th Avenue, Holtz Buiding, East Tower, 2169, Miami, FL 33136 | 2019-04-10 |
| Find all providers in zip 33136 | ||||
| Taxonomy Code | 207XS0114X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Adult Reconstructive Orthopaedic Surgery |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114169018 | Alejandro Manuel Diaz | Orthopaedic Surgery | 9380 Sw 150th St Ste 270, Miami, FL 33176 | 2009-03-24 |
| 1396865606 | Michele Raul D'apuzzo | Orthopaedic Surgery | 1611 Nw 12th Ave Ste 600, Miami, FL 33136-1005 | 2007-03-30 |
| 1942397005 | Timothy J Forness Mdpa | Orthopaedic Surgery | 2655 S Bayshore Dr Apt 514, Miami, FL 33133-5416 | 2006-10-09 |
| 1164840948 | David Alejandro Silva Iacobelli | Orthopaedic Surgery | 1201 Nw 16th St, Miami, FL 33125-1624 | 2014-03-31 |
| 1235454638 | Raul Gustavo Gosthe | Orthopaedic Surgery | 9380 Sw 150th St, Suite 270, Miami, FL 33176-7947 | 2010-03-29 |
| 1548291412 | Juan Carlos Suarez | Orthopaedic Surgery | 8940 N Kendall Dr Ste 601e, Miami, FL 33176-2150 | 2006-07-06 |
| 1285685123 | Rene Francisco Rodriguez | Orthopaedic Surgery | 1201 Nw 16th St, Miami, FL 33125-1624 | 2006-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891289377 | Ortho Florida, LLC | Orthopaedic Surgery | 5130 Linton Blvd Ste B2, Delray Beach, FL 33484-6595 | 2018-06-19 |
| 1801318423 | Royal Palm Beach Rehab, Corp | Orthopaedic Surgery | 600 University Blvd Ste 104, Jupiter, FL 33458-2778 | 2017-07-14 |
| 1902255854 | Carlos Segovia | Orthopaedic Surgery | 17779 Sw 2nd Street, Pembroke Pines, FL 33029 | 2016-06-10 |
| 1437520509 | Timothy Joseeph Forness | Orthopaedic Surgery | 3802 Dogwood Ave, Palm Beach Gardens, FL 33410-4755 | 2015-10-14 |
| 1275927766 | Robert O'leary | Orthopaedic Surgery | 1150 Campo Sano Ave Fl 2, Coral Gables, FL 33146-1174 | 2015-03-24 |
| 1134548019 | Alexander David Gaukhman | Orthopaedic Surgery | 670 Glades Rd Ste 300, Boca Raton, FL 33431-6464 | 2014-04-08 |
| 1124379706 | Elvis Grandic Md Pa | Orthopaedic Surgery | 7744 Dawson Ct, Lake Worth, FL 33467-7719 | 2012-09-24 |
| 1104184951 | Thomas Jacob Seales | Orthopaedic Surgery | 2021 Nw 136th Ave Apt 284, Sunrise, FL 33323-5375 | 2012-04-30 |
| 1558629527 | Tri-county Orthopaedic Center, Pa | Orthopaedic Surgery | 765 Hwy 466, Lady Lake, FL 32159-6340 | 2012-04-27 |
| 1518233956 | Joshua Dov Rogozinski | Orthopaedic Surgery | 3716 University Blvd S., Suite 3, Jacksonville, FL 32216 | 2012-03-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.