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Manjul Derasari M.d.,p.a.
Specialist in Tampa, Florida
NPI 1407915929

Manjul Derasari M.d.,p.a. is a Specialist based in Tampa, FL. Manjul Derasari M.d.,p.a. practices in Tampa, FL. The NPI Number for Manjul Derasari M.d.,p.a. is 1407915929 and holds a License No. ME54111 (Florida).

The current practice location address for Manjul Derasari M.d.,p.a. is 1912 E Busch Blvd, Tampa, FL and can be reached out via phone at 813-933-5900 and via fax at 813-935-9687.

Location: 1912 E Busch Blvd, Tampa, FL, 33612-8666
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1407915929
Provider Name
Manjul Derasari M.d.,p.a.
Credential
Provider Entity Type
Organization
Address
1912 E Busch Blvd, Tampa, FL, 33612-8666
Phone Number
813-933-5900
Fax Number
813-935-9687
Provider Enumeration Date
12/08/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2720607 01 FL AETNA
11609 01 FL BC BS
064751900 05 FL
institution
Provider Business Practice Location Address Details
Address
1912 E Busch Blvd
City
Tampa
State
Florida
Zip
33612-8666
Phone Number
813-933-5900
Fax Number
813-935-9687
person
Provider Business Mailing Address Details
Address
1912 E Busch Blvd
City
Tampa
State
Florida
Zip
33612-8666
Phone Number
813-933-5900
Fax Number
813-935-9687
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
ME54111 (Florida)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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