Provider Demographics
NPI:1942403183
Name:TATINI, PRASANTI (MD)
Entity Type:Individual
Prefix:DR
First Name:PRASANTI
Middle Name:
Last Name:TATINI
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 1:1820 MICCOSUKEE COMMONS DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5432
Mailing Address - Country:US
Mailing Address - Phone:850-765-8120
Mailing Address - Fax:850-270-7733
Practice Address - Street 1:1820 MICCOSUKEE COMMONS DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5432
Practice Address - Country:US
Practice Address - Phone:850-765-8120
Practice Address - Fax:850-270-7733
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1105022084P0800X, 2084P0800X
MI4301087945390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program