Susheela Ravindra Nathan, MD

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

ME 27079 Issued in FL

Practice address

14555 Cortez Blvd
Brooksville, FL 34613-6003

Phone

(352) 796-6000

Fax

(305) 667-0239

NPI assigned

Jun 19, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427253525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 SW 74TH ST",
            "address_2": "SUITE 202",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331435165",
            "telephone_number": "305-665-4614",
            "fax_number": "305-667-0239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14555 CORTEZ BLVD",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346136003",
            "telephone_number": "352-796-6000",
            "fax_number": "305-667-0239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVINDRA NATHAN",
        "first_name": "SUSHEELA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "FL",
            "license": "ME 27079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Amanda Rao
• Ravishankar L Rao, MD
• Angenette Purcell Rashad, M.D.
• Rida Rasool, DO
• Dhruv Ratra, DO
• Muttathil P Ravindranathan, M.D.
• Ravishankar L Rao M D PA
• Keval Ray, DO
• Kimbrelee Kaye Ray, PMHNP-BC
• Mohammad Hassan Razzaq, DO

• Pediatric Adolescent Medicine Physician in Brooksville, FL
• Providers in Brooksville, FL by specialty
• Pediatric Adolescent Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.