Individual
THAMOTHARAMPILLAI SIVARAJ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
975 BAPTIST WAY, HOMESTEAD, FL 33033-7600
(786) 243-8000
Mailing address
8912 NW 161ST TER, MIAMI LAKES, FL 33018-1426
(919) 622-4294
(919) 622-4294
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
9901648
NC
207R00000X
Internal Medicine Physician
9901648
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89127WJ
—
NC
Enumeration date
01/05/2007
Last updated
10/15/2020
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