Provider Demographics
NPI:1659514305
Name:BIRUSINGH, RHEA JEANNINE (MD)
Entity Type:Individual
Prefix:DR
First Name:RHEA
Middle Name:JEANNINE
Last Name:BIRUSINGH
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:PO BOX 1345
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-1345
Mailing Address - Country:US
Mailing Address - Phone:352-343-3434
Mailing Address - Fax:352-589-4140
Practice Address - Street 1:1000 WATERMAN WAY
Practice Address - Street 2:PATHOLOGY
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778
Practice Address - Country:US
Practice Address - Phone:352-253-3374
Practice Address - Fax:352-589-4140
Is Sole Proprietor?:No
Enumeration Date:2009-04-10
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME108070207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5H771Medicare PIN