Provider Demographics
NPI:1659530384
Name:NAIR, VASUDHA VASANT
Entity Type:Individual
Prefix:MRS
First Name:VASUDHA
Middle Name:VASANT
Last Name:NAIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11301 GLENMONT DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33635-1531
Mailing Address - Country:US
Mailing Address - Phone:813-925-3321
Mailing Address - Fax:813-925-3331
Practice Address - Street 1:2364 DREW ST
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-3310
Practice Address - Country:US
Practice Address - Phone:727-723-1100
Practice Address - Fax:727-723-1135
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT18787225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist