Provider Demographics
NPI:1730115007
Name:MUKHERJEE, MANISHI (MD)
Entity Type:Individual
Prefix:DR
First Name:MANISHI
Middle Name:
Last Name:MUKHERJEE
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 1:5880 49TH ST N
Mailing Address - Street 2:SUITE 206N
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33709-2150
Mailing Address - Country:US
Mailing Address - Phone:727-526-9899
Mailing Address - Fax:727-526-6296
Practice Address - Street 1:5880 49TH ST N
Practice Address - Street 2:SUITE 206N
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-2150
Practice Address - Country:US
Practice Address - Phone:727-526-9899
Practice Address - Fax:727-526-6296
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0027749207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD85976Medicare UPIN
FL52934Medicare ID - Type Unspecified