S Manjula Jegasothy MD PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

S MANJULA JEGASOTHY MD PA

Practice address

135 San Lorenzo Ave Ste 870
Coral Gables, FL 33146-1879

Phone

(305) 569-0067

Fax

(305) 569-0110

NPI assigned

Dec 5, 2007

Organization subpart

No

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

Authorized official

Name

Shevanti Manjula Jegasothy, MD

Title

Owner

Phone

(305) 569-0067

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360627200000",
    "number": "1760664387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 SAN LORENZO AVE STE 870",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331461879",
            "telephone_number": "305-569-0067",
            "fax_number": "305-569-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 SAN LORENZO AVE STE 870",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331461879",
            "telephone_number": "305-569-0067",
            "fax_number": "305-569-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S MANJULA JEGASOTHY MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-05",
        "last_updated": "2013-02-12",
        "status": "A",
        "authorized_official_last_name": "JEGASOTHY",
        "authorized_official_first_name": "SHEVANTI",
        "authorized_official_middle_name": "MANJULA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-569-0067",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Coral Gables, FL
• Providers in Coral Gables, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2013; 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.