Individual
DR. PALANISAMY RATHINASAMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
205 S.MOON AVE, SUITE 102, BRANDON, FL 33511-5716
(813) 681-4644
(813) 654-4486
Mailing address
205 S.MOON AVE, SUITE 102, BRANDON, FL 33511-5716
(813) 681-4644
(813) 654-4486
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME0046555
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01110
UNIVERSAL
—
01
—
020006402
R.R.MEDICARE
—
05
—
040231100
—
FL
01
—
0571459001
CIGNA HMO
—
01
—
204455
AVMED
—
01
—
205115
AMERIGROUP
—
01
—
30840
BLUECROSS/BLUESHIELD
FL
01
—
4111547
AETNA
—
01
—
5796381
GHI
—
Enumeration date
10/27/2006
Last updated
10/07/2011
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