Provider Demographics
NPI:1780662684
Name:PLACHERIL, JOSEPH T M (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:T M
Last Name:PLACHERIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8623 54TH DRIVE EAST
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34202
Mailing Address - Country:US
Mailing Address - Phone:941-758-1285
Mailing Address - Fax:941-739-6168
Practice Address - Street 1:8623 54TH DRIVE EAST
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34202
Practice Address - Country:US
Practice Address - Phone:941-758-1285
Practice Address - Fax:941-739-6168
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0071734208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL32915OtherBLUE CROSS BLUE SHIELD
FLG46315Medicare UPIN