Provider Demographics
NPI:1497727382
Name:VENKATAPERUMAL, SATISH (MD)
Entity Type:Individual
Prefix:
First Name:SATISH
Middle Name:
Last Name:VENKATAPERUMAL
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 1:5365 W ATLANTIC AVE
Mailing Address - Street 2:SUITE 504
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-8172
Mailing Address - Country:US
Mailing Address - Phone:561-241-9300
Mailing Address - Fax:561-241-9339
Practice Address - Street 1:4219 US HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-5906
Practice Address - Country:US
Practice Address - Phone:727-939-2230
Practice Address - Fax:727-847-5349
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME80382208VP0014X, 208VP0000X
FLME 803822085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL16063TOtherMEDICARE 34259
FL16063OtherBLUE CROSS INDIVIDUAL NUMBER
FL16063UOtherMEDICARE PTAN 34259A
FL272482100Medicaid
FLI32245Medicare UPIN
FL272482100Medicaid
FL239216OtherAVMED GROUP
FL16063OtherBLUE CROSS INDIVIDUAL NUMBER