Provider Demographics
NPI:1548493323
Name:PASALA, TILAK (MD)
Entity type:Individual
Prefix:DR
First Name:TILAK
Middle Name:
Last Name:PASALA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5352 LINTON BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6514
Mailing Address - Country:US
Mailing Address - Phone:561-498-2249
Mailing Address - Fax:614-980-3205
Practice Address - Street 1:5352 LINTON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6514
Practice Address - Country:US
Practice Address - Phone:561-498-2249
Practice Address - Fax:614-980-3205
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-27
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME163651207RI0011X
NJ25MA09909700207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology