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Contact Information

MANJUL D DERASARI
36763 EILAND BLVD STE 201
ZEPHYRHILLS, FL33542
 Phone: 813-977-6688
 Fax: 813-355-5060
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
 

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for MANJUL D DERASARI · (Male)

NPI # 1912969775
Status Active
Credentials
Entity Individual
Enumeration date 04/05/2006
Last updated 06/17/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • FL License # ME0054111
  • FL License # ME54111
  • FL Medicaid 064751900
  • FL Other 11609R MEDICARE PTAN
  • FL Other 39715 MEDICARE PTAN GROUP
Hospital affiliation(s)
  • ST JOSEPH'S HOSPITAL - (Acute Care)
    3001 W MARTIN LUTHER KING JR BLVD
    TAMPA, FL 33677
  • TAMPA GENERAL HOSPITAL - (Acute Care)
    1 TAMPA GENERAL CIR
    TAMPA, FL 33606
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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