Provider Demographics
NPI:1083844278
Name:SUBRAMANIAN, KATHIR SELVAN (MD)
Entity Type:Individual
Prefix:
First Name:KATHIR SELVAN
Middle Name:
Last Name:SUBRAMANIAN
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 1:4101 NW 4TH ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2850
Mailing Address - Country:US
Mailing Address - Phone:954-681-4088
Mailing Address - Fax:954-678-0166
Practice Address - Street 1:4101 NW 4TH ST
Practice Address - Street 2:SUITE 104
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2850
Practice Address - Country:US
Practice Address - Phone:954-681-4088
Practice Address - Fax:954-678-0166
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME130244207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology