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Organization

PALANISAMY RATHINASAMY MD PA

Active
Other names
Surgical Associates of Tampa Bay
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KALYANAMATHY RATHINASAMY (OFFICE MANAGER)
(813) 681-4644
Entity
Organization

Contact information

Practice address
205 S.MOON AVE, SUITE 102, BRANDON, FL 33511-5716
(813) 681-4644
(813) 654-4486
Mailing address
205 S.MOON AVE, SUITE 102, BRANDON, FL 33511-5716
(813) 681-4644
(813) 654-4486

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
265818600
FL
01
5410665
AETNA
01
CD0347
R.R.MEDICARE
Enumeration date
01/30/2007
Last updated
07/25/2012
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