Provider Demographics
NPI:1346681459
Name:GHOSH, SATHI (MD)
Entity Type:Individual
Prefix:
First Name:SATHI
Middle Name:
Last Name:GHOSH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10125 NW 69TH MNR
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33076-2904
Mailing Address - Country:US
Mailing Address - Phone:864-497-8775
Mailing Address - Fax:954-775-0171
Practice Address - Street 1:1500 N UNIVERSITY DR STE 202
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-6072
Practice Address - Country:US
Practice Address - Phone:954-774-2389
Practice Address - Fax:954-775-0171
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-17
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME1315832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program