MANJUL D DERASARI (NPI# 1912969775) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912969775 |
| Entity Type | Individual |
| Full Name | MANJUL D DERASARI |
| Credential | MD PA |
| Practice Address |
36763 Eiland Blvd Ste 201 Zephyrhills FL 33542 |
| Mailing Address |
38135 Market Sq Zephyrhills FL 33542-7505 |
| Practice Telephone | 8139776688 |
| Practice Fax Number | 8133555060 |
| Mailing Telephone | 3525670188 |
| Mailing Fax Number | 8133555084 |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2019-06-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | ME0054111 | FL | Other Service Providers |
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
ME54111 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 064751900 | 05 | |
| FL | MEDICARE PTAN GROUP | 39715 | 01 |
| FL | MEDICARE PTAN | 11609R | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1912 E Busch Blvd, Tampa, FL 336128666 | 8139335900 | 8139359687 |
| Street Address |
36763 EILAND BLVD STE 201 |
| City | ZEPHYRHILLS |
| State | FL |
| Zip Code | 33542 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902242597 | Resham Datta | Anesthesiology | 36763 Eiland Blvd Ste 201, Zephyrhills, FL 33542-0600 | 2013-05-22 |
| 1295054526 | Carol Rodriguez | Nurse Practitioner | 36763 Eiland Blvd Ste 201, Zephyrhills, FL 33542-0600 | 2010-05-26 |
| 1003852625 | Gabriel John Somori | Anesthesiology | 36763 Eiland Blvd Ste 201, Zephyrhills, FL 33542-0600 | 2006-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487260469 | Caring Cherubs LLC | Homemaker | 38336 5th Ave, Zephryhills, FL 33542 | 2020-09-16 |
| 1457906356 | Appolonie Nahishakiye | Social Worker | 38439 18th Avenue, Zephyrhills, FL 33542 | 2019-08-07 |
| 1326537846 | Justin Lane Roark | Registered Nurse | 4141 Transue Drive, Zephyrhills, FL 33542 | 2018-05-10 |
| 1497256879 | Michelle Medical Solutions Inc | Durable Medical Equipment & Medical Supplies | 39009 County Road 54, Zephyrhills, FL 33542 | 2018-02-22 |
| 1699275891 | Layne Medical Supply, Inc. | Durable Medical Equipment & Medical Supplies | 39047 County Road 54, Zephyrhills, FL 33542 | 2018-02-15 |
| 1821348525 | Florida Pharmacy Solutions, Inc | Pharmacy | 38444 5th Avenue, Zephyrhills, FL 33542 | 2012-09-11 |
| 1053667469 | Derrick S Tipton | Physical Therapy Assistant | 5939 Gall Blvd., Zephyrhills, FL 33542 | 2012-08-03 |
| 1891078127 | Stacy Marie Hill | Pharmacist | 6494 Gall Blvd, Zephyrhills, FL 33542 | 2011-09-22 |
| 1568766111 | Jamie H. Barron, Psy.d. P.a. | Psychologist | 37800 S.r. 54 West, Zephyrhills, FL 33542 | 2010-12-22 |
| 1245377985 | Family Home Health Services LLC | Home Health | 38196 Medical Center, Zephyrhills, FL 33542 | 2007-01-31 |
| Find all providers in zip 33542 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659979706 | Specialty Physician Services. LLC | Pain Medicine | 9150 Sw 87th Ave Ste 200, Miami, FL 33176-2313 | 2020-10-12 |
| 1700403847 | Advanced Interventional Pain Center Fl | Pain Medicine | 1831 N Belcher Rd Ste E1, Clearwater, FL 33765-1442 | 2020-07-05 |
| 1770108110 | The Neomedicine Institute LLC | Pain Medicine | 2510 Nw 97th Ave Ste 110, Doral, FL 33172-1407 | 2020-06-11 |
| 1316583362 | Lisa M Gonzalez | Pain Medicine | 8136 Centralia Ct Ste 103, Leesburg, FL 34788-3757 | 2019-11-25 |
| 1306488820 | Alberto Rivera-sanchez Pa | Pain Medicine | 201 W Canton Ave Ste 275, Winter Park, FL 32789-3148 | 2019-10-16 |
| 1912560798 | Jacksonville Spine Center Pa | Pain Medicine | 2349 Village Square Pkwy Ste 107, Fleming Island, FL 32003-4319 | 2019-04-17 |
| 1942765144 | Nixpain LLC | Pain Medicine | 2750 Ne 14th St, Fort Lauderdale, FL 33304-1611 | 2019-02-01 |
| 1346737749 | Ceda Orthopedics Group, LLC. | Pain Medicine | 815 Nw 57th Avenue, Ste. 202, Miami, FL 33126 | 2018-04-20 |
| 1174025001 | Lighthouse Point Surgery Center LLC | Pain Medicine | 1821 Ne 25th St Ste 100, Lighthouse Point, FL 33064-7744 | 2018-03-07 |
| 1801394440 | Neuspine Therapy LLC | Pain Medicine | 12880 Us 301, Dade City, FL 33525-5801 | 2018-01-29 |
| Find all providers with the same taxonomy | ||||
| City | ZEPHYRHILLS |
| Zip Code | 33542 |
Please comment or provide details below to improve the information on MANJUL D DERASARI.
| 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.