Provider Demographics
NPI:1477729408
Name:SIVAPRAKASAPILLAI, NIRMALA (MD)
Entity Type:Individual
Prefix:
First Name:NIRMALA
Middle Name:
Last Name:SIVAPRAKASAPILLAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NIRMALA
Other - Middle Name:
Other - Last Name:PILLAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1301 2ND AVE SW
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-3120
Mailing Address - Country:US
Mailing Address - Phone:727-584-7706
Mailing Address - Fax:727-581-2786
Practice Address - Street 1:1301 2ND AVE SW
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-3120
Practice Address - Country:US
Practice Address - Phone:727-584-7706
Practice Address - Fax:727-581-2786
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS21302207RG0100X
FLME104261207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015064700Medicaid
FL1500MOtherBCBS
FLP01491267OtherRAILROAD MEDICARE
FL0460101OtherCIGNA
FL0460101OtherCIGNA