Provider Demographics
NPI:1518083914
Name:GULF TO BAY CARDIO SURERY
Entity Type:Organization
Organization Name:GULF TO BAY CARDIO SURERY
Other - Org Name:GULF TO BAY CARDIO SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:NARAYANA MURTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:RATTEHALLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-263-8138
Mailing Address - Street 1:PO BOX 788
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-0788
Mailing Address - Country:US
Mailing Address - Phone:727-861-2823
Mailing Address - Fax:
Practice Address - Street 1:5113 RUE VENDOME
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33558-2860
Practice Address - Country:US
Practice Address - Phone:727-861-2823
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK1283Medicare UPIN