PURANDATH LALL (NPI# 1992777338) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992777338 |
| Entity Type | Individual |
| Full Name | PURANDATH LALL |
| Credential | MD |
| Practice Address |
10080 Sw Innovation Way Ste 201 Port St Lucie FL 34987-2129 |
| Mailing Address |
Po Box 417 Stuart FL 34995-0417 |
| Practice Telephone | 7723443811 |
| Practice Fax Number | 7723443890 |
| Mailing Telephone | 7722232832 |
| Mailing Fax Number | 7722235646 |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2020-10-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
125959 | FL | Allopathic & Osteopathic Physicians |
| N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
47964 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | FLORIDA BLUE | W81GM | 01 |
| MN | 182855000 | 05 | |
| FL | 020817900 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1920 Sw 20th Pl, #100, Ocala, FL 344717881 | 3522371212 | 3522370066 |
| Street Address |
10080 SW INNOVATION WAY STE 201 |
| City | PORT ST LUCIE |
| State | FL |
| Zip Code | 34987-2129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629501911 | Lisai Zhang | Family Medicine | 10080 Sw Innovation Way Ste 201, Port St Lucie, FL 34987-2129 | 2017-04-04 |
| 1164801130 | Konstantin Alekseyenko | Family Medicine | 10080 Sw Innovation Way Ste 201, Port St Lucie, FL 34987-2129 | 2015-05-23 |
| 1720498470 | Josue Limage | Family Medicine | 10080 Sw Innovation Way Ste 201, Port St Lucie, FL 34987 | 2014-05-03 |
| 1356777650 | Jennifer Moody | Nurse Practitioner | 10080 Sw Innovation Way Ste 201, Port St Lucie, FL 34987-2129 | 2013-09-18 |
| 1639425986 | Kathie Kowalczyk | Psychiatry & Neurology | 10080 Sw Innovation Way Ste 201, Port St Lucie, FL 34987-2129 | 2012-07-24 |
| 1740543057 | Eric Williams Owings | Surgery | 10080 Sw Innovation Way Ste 201, Port St Lucie, FL 34987-2129 | 2012-06-21 |
| 1750672200 | Avneet Vig | Internal Medicine | 10080 Sw Innovation Way Ste 201, Port St Lucie, FL 34987-2129 | 2011-05-02 |
| 1669606109 | Juan C Bird | Internal Medicine | 10080 Sw Innovation Way Ste 201, Port St Lucie, FL 34987-2129 | 2009-05-13 |
| 1295796290 | Mona F Fakhry | Internal Medicine | 10080 Sw Innovation Way Ste 201, Port St Lucie, FL 34987-2129 | 2006-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093299604 | Karen Cecilia Wong Li James | Registered Nurse | 10024 Sw Glenbrook Drive, Port Saint Lucie, FL 34987 | 2018-09-19 |
| 1134646151 | B & T Diagnostics LLC | Clinical Medical Laboratory | 11350 Sw Village Pkwy Ste 323, Port Saint Lucie, FL 34987 | 2017-08-30 |
| 1538684048 | Transport With Care, LLC | Non-emergency Medical Transport (VAN) | 1850 Sw Our Ct, Port Saint Lucie, FL 34987 | 2017-08-04 |
| 1154859825 | True Path Diagnostics, LLC | Clinical Medical Laboratory | 11350 Sw Village Pkwy Ste 309, Port St Lucie, FL 34987 | 2017-05-25 |
| 1316326515 | Aleksey Alekseyenko | Family Medicine | Mhpg Primary Care @ Tradition Health Park II, 10080 Sw Innovation Way Suite 201, Port St Lucie, FL 34987 | 2015-05-21 |
| 1053658583 | Tameka Argo | Contractor | 7664 Germany Canal Road, Fort Pierce, FL 34987 | 2013-01-03 |
| 1780967976 | Mennette J Colon | Specialist/Technologist, Other | 1970 Sw Glendale St., Port Saint Lucie, FL 34987 | 2011-09-23 |
| 1366416257 | Cynthia A Dolan | Dermatology | 10080 Sw Innovation Way Ste 301, Port St Lucie, FL 34987 | 2006-02-15 |
| 1205829074 | Andres M Reyes | Internal Medicine | 10050 Nw Innovation Way, Suite 102, Port St Lucie, FL 34987 | 2005-08-26 |
| 1013296110 | Karen Lee Harris | Pharmacist | 11995 Sw Elsinore Dr, Port Saint Lucie, FL 34987-1907 | 2011-08-08 |
| Find all providers in zip 34987 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538385885 | Vain Clinic,llc | Surgery | 1599 Se Lennard Rd, Port St Lucie, FL 34952-6542 | 2007-04-17 |
| 1063433555 | Edward J Scheel | Surgery | 1801 Se Hillmoor Dr, Suite A101, Port St Lucie, FL 34952-7553 | 2006-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104394857 | George Scott Hall Sr. | Surgery | 9 Marsh Creek Rd, Fernandina Beach, FL 32034-6413 | 2018-11-09 |
| 1316413115 | Fox Vascular Experts, LLC | Surgery | 2699 Stirling Rd Ste A301302, Fort Lauderdale, FL 33312-6517 | 2018-10-18 |
| 1114417508 | Vascular Center of Naples Inc. | Surgery | 5490 Bryson Dr Ste 201, Naples, FL 34109 | 2018-05-11 |
| 1598267593 | Joseph D Stillword, Md | Surgery | 800 Zeagler Dr Ste 320, Palatka, FL 32177-3827 | 2018-03-06 |
| 1386157006 | Beatriz Lam | Surgery | 2001 West 68 St, Cvicu, Hialeah, FL 33016 | 2017-11-16 |
| 1811421092 | Sunrise Vascular Center | Surgery | 8555 Nw 165th Ter, Miami Lakes, FL 33016-6138 | 2017-04-14 |
| 1962891838 | Global Trauma Systems, Inc | Surgery | 126 Se Mira Lavella, Port Saint Lucie, FL 34984-6615 | 2015-01-15 |
| 1184013450 | Vas-q-lar, Inc | Surgery | 6187 Nw 167th St, Suite H13, Hialeah, FL 33015-4340 | 2015-01-09 |
| 1396147138 | Usa Vein Clinics of Miami, LLC | Surgery | 1711 E Hallandale Beach Blvd Ste B, Hallandale Beach, FL 33009-4621 | 2014-09-24 |
| 1114336021 | Florida Vein Center, Inc | Surgery | 6050 53rd Ave E Unit A, Bradenton, FL 34203-9700 | 2014-08-05 |
| Find all providers with the same taxonomy | ||||
| City | PORT ST LUCIE |
| Zip Code | 34987 |
Please comment or provide details below to improve the information on PURANDATH LALL.
| 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.