Individual
MR. THANESSERI BASKARAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 E SHERIDAN RD, MELBOURNE, FL 32901-3122
(321) 639-5709
Mailing address
400 E SHERIDAN RD, MELBOURNE, FL 32901-3122
(321) 639-5709
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME0077201
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
255528000
—
FL
Enumeration date
06/02/2006
Last updated
09/10/2010
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