Provider Demographics
NPI:1780859660
Name:ESWARAN, MANIVEL KUMARAN (MD)
Entity Type:Individual
Prefix:
First Name:MANIVEL
Middle Name:KUMARAN
Last Name:ESWARAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4340 W NEWBERRY RD STE 301
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-2557
Mailing Address - Country:US
Mailing Address - Phone:352-372-9414
Mailing Address - Fax:352-271-5393
Practice Address - Street 1:1921 WALDEMERE ST STE 512
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2941
Practice Address - Country:US
Practice Address - Phone:941-917-3270
Practice Address - Fax:941-917-3275
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD434716207R00000X
TXBP10046298207RE0101X
OH126003207RE0101X
FLME135708207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine