Individual
DEEPTHI PREMARATNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6200 SW 73RD ST, SOUTH MIAMI, FL 33143-4679
(786) 242-4575
Mailing address
255 W MICHIGAN AVE, PO BOX 1123, JACKSON, MI 49201-2218
(517) 787-6440
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME95458
FL
Other
Enumeration date
09/15/2006
Last updated
07/21/2022
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