Provider Demographics
NPI:1770797573
Name:BIKKASANI, RAM & HELLSTERN, MD P.A.
Entity type:Organization
Organization Name:BIKKASANI, RAM & HELLSTERN, MD P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PURNACHANDER
Authorized Official - Middle Name:R
Authorized Official - Last Name:BIKKASANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-563-2450
Mailing Address - Street 1:10421 UNIVERSITY CENTER DR
Mailing Address - Street 2:SUITE 500A
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-6427
Mailing Address - Country:US
Mailing Address - Phone:813-549-1046
Mailing Address - Fax:813-549-1051
Practice Address - Street 1:10421 UNIVERSITY CENTER DR
Practice Address - Street 2:SUITE 500A
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-6427
Practice Address - Country:US
Practice Address - Phone:813-549-1046
Practice Address - Fax:813-549-1051
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BIKKASANI RAM HELLSTERN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-10
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK2282AMedicare ID - Type Unspecified