Provider Demographics
NPI:1568410900
Name:SASTRY, ROHINI (MD)
Entity Type:Individual
Prefix:DR
First Name:ROHINI
Middle Name:
Last Name:SASTRY
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 1:1414 EAST MAIN STREET
Mailing Address - Street 2:SUITE 3
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748
Mailing Address - Country:US
Mailing Address - Phone:352-728-2110
Mailing Address - Fax:352-728-2115
Practice Address - Street 1:1414 EAST MAIN STREET
Practice Address - Street 2:SUITE 3
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748
Practice Address - Country:US
Practice Address - Phone:352-728-2110
Practice Address - Fax:352-728-2115
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 62040207LP2900X
FLME62040207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL17984OtherBLUE SHIELD PROV #
FLF38673Medicare UPIN
FL17984OtherBLUE SHIELD PROV #