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Purandath Lall, MD
Vascular Surgery Physician in Port St Lucie, Florida
NPI 1992777338

Purandath Lall is a Vascular Surgery Physician based in Stuart, FL and is specialized in Vascular Surgery. Purandath Lall practices in Port St Lucie, FL and has the professional credentials of MD. The NPI Number for Purandath Lall is 1992777338 and holds a License No. 47964 (Florida).

The current practice location address for Purandath Lall is 10080 Sw Innovation Way Ste 201, Port St Lucie, FL and can be reached out via phone at 772-344-3811 and via fax at 772-344-3890.

Location: 10080 Sw Innovation Way Ste 201, Port St Lucie, FL, 34995-0417
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1992777338
Provider Name
Purandath Lall
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
10080 Sw Innovation Way Ste 201, Port St Lucie, FL, 34995-0417
Phone Number
772-344-3811
Fax Number
772-344-3890
Provider Enumeration Date
02/01/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
020817900 05 FL
182855000 05 MN
W81GM 01 FL FLORIDA BLUE
institution
Provider Business Practice Location Address Details
Address
10080 Sw Innovation Way Ste 201
City
Port St Lucie
State
Florida
Zip
34987-2129
Phone Number
772-344-3811
Fax Number
772-344-3890
person
Provider Business Mailing Address Details
Address
10080 Sw Innovation Way Ste 201
City
Port St Lucie
State
Florida
Zip
34987-2129
Phone Number
772-344-3811
Fax Number
772-344-3890
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Surgery
Speciality
Vascular Surgery
Taxonomy
2086S0129X
License No.
47964 (Minnesota)
Definition
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
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