Provider Demographics
NPI:1609566793
Name:T. SUBRAMANIAN MD PA
Entity Type:Organization
Organization Name:T. SUBRAMANIAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THONDIKULAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:SUBRAMANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-423-6463
Mailing Address - Street 1:1226 TUSCANY DR
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-7073
Mailing Address - Country:US
Mailing Address - Phone:727-423-6463
Mailing Address - Fax:727-375-2683
Practice Address - Street 1:1226 TUSCANY DR
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-7073
Practice Address - Country:US
Practice Address - Phone:727-423-6463
Practice Address - Fax:727-375-2683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty