Provider Demographics
NPI:1033391990
Name:ROHINI SASTRY M.D. PA
Entity Type:Organization
Organization Name:ROHINI SASTRY M.D. PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROHINI
Authorized Official - Middle Name:
Authorized Official - Last Name:SASTRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-728-2110
Mailing Address - Street 1:1414 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-5329
Mailing Address - Country:US
Mailing Address - Phone:352-728-2110
Mailing Address - Fax:352-728-2115
Practice Address - Street 1:2785 S BAY ST
Practice Address - Street 2:
Practice Address - City:EUSTIS
Practice Address - State:FL
Practice Address - Zip Code:32726-6591
Practice Address - Country:US
Practice Address - Phone:352-728-2110
Practice Address - Fax:352-728-2115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL17984YOtherBC/BS
FL1568410900OtherNPI #
FL17984YOtherBC/BS
FL1568410900OtherNPI #