Provider Demographics
NPI:1598746711
Name:SASTRY, NARENDRA S (MD)
Entity Type:Individual
Prefix:DR
First Name:NARENDRA
Middle Name:S
Last Name:SASTRY
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 1:3100 E FLETCHER AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-4613
Mailing Address - Country:US
Mailing Address - Phone:813-615-7075
Mailing Address - Fax:813-615-7226
Practice Address - Street 1:3100 E FLETCHER AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613
Practice Address - Country:US
Practice Address - Phone:813-615-7075
Practice Address - Fax:813-615-7226
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME63006208G00000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006434900Medicaid
FL371150100Medicaid
FLE85126Medicare UPIN
FL18090WMedicare PIN
FL18090ZMedicare ID - Type UnspecifiedMEDICARE NUMBER