Dr. Kalyani Manjul Derasari
M.D. | Pediatric Adolescent Medicine | Female
Dr. Kalyani Manjul Derasari, M.D. is a Tampa, Florida based Pediatric doctor with medical specialization in
Pediatric Adolescent Medicine. Dr. Kalyani Manjul Derasari is also known as
Kalyani Manjul Derasari.
Current practice location of Dr. Kalyani Manjul Derasari is
4202 E Fowler Ave, Shs-100, Tampa, Florida - 33620-9951. She can be contacted on phone at
813-974-2331 and fax number 813-974-7181.
Dr. Kalyani Manjul Derasari is a sole proprietor of her business.
NPI number (Unique professional ID) for Dr. Kalyani Manjul Derasari is
1689835357 which was assigned by NPPES on 24 Jun, 2008 and it was last updated on 29 Oct, 2020.
Dr. Kalyani Manjul Derasari license number is
ME52057 for Pediatrics Adolescent Medicine (2080A0000X) in Florida.
Dr. Kalyani Manjul Derasari specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Dr. Kalyani Manjul Derasari basic information including her official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
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| Provider Name : | Dr. Kalyani Manjul Derasari |
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| Other Name : | Kalyani Manjul Derasari |
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| Credential : | M.D. |
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| Gender : | Female |
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Business Address:
Dr. Kalyani Manjul Derasari address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 4202 E Fowler Ave, Shs-100
Tampa, FL, 33620-9951
United States |
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| Phone Number : | 813-974-2331 |
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| Fax Number : | 813-974-7181 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1689835357 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 24 Jun, 2008 |
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| Last Updated On : | 29 Oct, 2020 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Kalyani Manjul Derasari are as mentioned. Primary taxonomy code for Dr. Kalyani Manjul Derasari, M.D. is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | ME52057 | FL |
Legacy Identifiers:
Other legacy medical identifiers of Dr. Kalyani Manjul Derasari such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 000199700 | MEDICAID | FL | |
| 05667 | Other | FL | BLUE CROSS BLUE SHIELD |
Endpoints:
Endpoints provide a simple, secure, scalable, and standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet. It is used by EHR systems (Electronic Health Records).
| Endpoint Type | Endpoint | Affiliation | Use | Content | Address |
|---|
DIRECT
(Direct Messaging Address) | kderasari91643@direct.tgh.org
| No affiliation |
|
| 4202 E FOWLER AVE, SHS-100
TAMPA, FL, 33620-9951
United States |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | Po Box 917770
Orlando, FL, 32891-0001
United States |
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| Phone Number : | 813-974-2201 |
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| Fax Number : | 813-974-2812 |
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Business Location:
Patients can refer following map for directions to
Dr. Kalyani Manjul Derasari practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.