Provider Demographics
NPI:1245332675
Name:SARAN, AVTAR SINGH (MD)
Entity type:Individual
Prefix:DR
First Name:AVTAR
Middle Name:SINGH
Last Name:SARAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21808 SR 54
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33549
Mailing Address - Country:US
Mailing Address - Phone:813-428-6142
Mailing Address - Fax:813-428-6190
Practice Address - Street 1:21808 STATE ROAD 54
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-6923
Practice Address - Country:US
Practice Address - Phone:813-428-6142
Practice Address - Fax:813-428-6190
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0412532084P0800X
FLME1149602084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009783300Medicaid
FL009783300Medicaid
C01946Medicare UPIN