Individual
SUBHASH KUMAR THAREJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
675 S BABCOCK ST, MELBOURNE, FL 32901-1459
(321) 951-1010
(321) 952-4038
Mailing address
675 S BABCOCK ST, MELBOURNE, FL 32901-1459
(321) 951-1010
(321) 952-4038
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME59791
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
055623800
—
FL
01
—
12115
BCBS
FL
Enumeration date
09/12/2005
Last updated
02/15/2023
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