Provider Demographics
NPI:1689698359
Name:CHERALA, SUNDARARAJ R (MD)
Entity type:Individual
Prefix:DR
First Name:SUNDARARAJ
Middle Name:R
Last Name:CHERALA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2825 N STATE ROAD 7 STE 203
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-5737
Mailing Address - Country:US
Mailing Address - Phone:954-688-6884
Mailing Address - Fax:833-895-1966
Practice Address - Street 1:2825 N STATE ROAD 7 STE 203
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5737
Practice Address - Country:US
Practice Address - Phone:954-688-6884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME143329208VP0014X
IL036077595208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04532058OtherBLUE CROSS BLUE SHIELD
K26500Medicare PIN
K49480Medicare PIN
IL04532058OtherBLUE CROSS BLUE SHIELD