Provider Demographics
NPI:1144201260
Name:RATTEHALLI, NARAYANA MURTHY S (MD)
Entity Type:Individual
Prefix:DR
First Name:NARAYANA MURTHY
Middle Name:S
Last Name:RATTEHALLI
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 1:7525 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-6502
Mailing Address - Country:US
Mailing Address - Phone:727-869-5551
Mailing Address - Fax:727-886-2329
Practice Address - Street 1:7525 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-6502
Practice Address - Country:US
Practice Address - Phone:727-869-5551
Practice Address - Fax:727-868-2329
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0068594174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL250949100Medicaid
FL27260ZMedicare ID - Type UnspecifiedMEDICARE NUMBER
FLG07731Medicare UPIN