Provider Demographics
NPI:1710006788
Name:RAO, NARASINHA SITARAM (PA)
Entity Type:Individual
Prefix:
First Name:NARASINHA
Middle Name:SITARAM
Last Name:RAO
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5202 SW 11TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-4700
Mailing Address - Country:US
Mailing Address - Phone:954-675-4854
Mailing Address - Fax:954-587-8631
Practice Address - Street 1:5202 SW 11 STREET
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317
Practice Address - Country:US
Practice Address - Phone:954-675-4854
Practice Address - Fax:954-587-8631
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9101142363AM0700X
GA005797363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPA 9101142OtherPA