Individual
DR. MANUS PRASERTHDAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1201 5TH AVE N, SUITE 208, ST PETERSBURG, FL 33705-1400
(727) 894-1122
(727) 894-0033
Mailing address
1201 5TH AVE N, SUITE 208, ST PETERSBURG, FL 33705-1400
(727) 894-1122
(727) 894-0033
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME33665
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0184828
CIGNA
FL
01
—
0666950
AETNA
FL
01
—
212769
AMERIGROUP
FL
01
—
3106012
UNITED HEALTHCARE
FL
Enumeration date
08/16/2005
Last updated
07/08/2007
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