Provider Demographics
NPI:1023045739
Name:NAIR, SOMNATH N (MD)
Entity Type:Individual
Prefix:
First Name:SOMNATH
Middle Name:N
Last Name:NAIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2623 S SEACREST BLVD
Mailing Address - Street 2:SUITE 118
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435
Mailing Address - Country:US
Mailing Address - Phone:561-742-4419
Mailing Address - Fax:561-742-4177
Practice Address - Street 1:2623 S SEACREST BLVD
Practice Address - Street 2:SUITE 118
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435
Practice Address - Country:US
Practice Address - Phone:561-742-4419
Practice Address - Fax:561-742-4177
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME71047207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL238894OtherAVMED
FL31548OtherBCBS
FL250367100Medicaid
FLP00287491OtherRAILROAD MEDICARE
FL238894OtherAVMED
C26410Medicare UPIN
FL31548YMedicare PIN