Provider Demographics
NPI:1164840674
Name:CHERIAN, NEENU ROSA (MD)
Entity type:Individual
Prefix:
First Name:NEENU
Middle Name:ROSA
Last Name:CHERIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NEENU
Other - Middle Name:ROSA
Other - Last Name:THEKKUMKATTIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 863407
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32886-3407
Mailing Address - Country:US
Mailing Address - Phone:941-917-2600
Mailing Address - Fax:941-917-7884
Practice Address - Street 1:1700 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239
Practice Address - Country:US
Practice Address - Phone:941-917-6574
Practice Address - Fax:941-917-4278
Is Sole Proprietor?:No
Enumeration Date:2014-04-01
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.132334208100000X
FLME136073208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation