Provider Demographics
NPI:1023069093
Name:NAMAN, SAHASRA (MD)
Entity type:Individual
Prefix:DR
First Name:SAHASRA
Middle Name:
Last Name:NAMAN
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 1:530 AUSTIN DR
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34688-8409
Mailing Address - Country:US
Mailing Address - Phone:727-742-0514
Mailing Address - Fax:
Practice Address - Street 1:5509 GRAND BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-3836
Practice Address - Country:US
Practice Address - Phone:727-232-0644
Practice Address - Fax:866-615-6461
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME48246207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110129250OtherRAILROAD MEDICARE
FL271077300Medicaid
FL110129250OtherRAILROAD MEDICARE
C07380Medicare UPIN