Provider Demographics
NPI:1760570360
Name:DURAI, PAL SADASIVAN (MD)
Entity Type:Individual
Prefix:
First Name:PAL
Middle Name:SADASIVAN
Last Name:DURAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14690 SPRING HILL DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-8102
Mailing Address - Country:US
Mailing Address - Phone:352-799-0046
Mailing Address - Fax:352-606-2857
Practice Address - Street 1:7505 ROTTINGHAM RD
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-2648
Practice Address - Country:US
Practice Address - Phone:727-495-5190
Practice Address - Fax:727-862-3193
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0044158207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013329400Medicaid
FL013329400Medicaid
FL62497Medicare ID - Type Unspecified