Provider Demographics
NPI:1154330165
Name:PILLAI, ANANTH K (MD)
Entity Type:Individual
Prefix:
First Name:ANANTH
Middle Name:K
Last Name:PILLAI
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 1:1265 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33830-5006
Mailing Address - Country:US
Mailing Address - Phone:863-534-3737
Mailing Address - Fax:863-533-6323
Practice Address - Street 1:1265 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830-5006
Practice Address - Country:US
Practice Address - Phone:863-534-3737
Practice Address - Fax:863-533-6323
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL29864208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics