Provider Demographics
NPI:1548557580
Name:PILLARISETTY, SANDEEP V (MD)
Entity type:Individual
Prefix:
First Name:SANDEEP
Middle Name:V
Last Name:PILLARISETTY
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 1:1507 S HIAWASSEE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-5706
Mailing Address - Country:US
Mailing Address - Phone:321-512-9208
Mailing Address - Fax:
Practice Address - Street 1:1507 S HIAWASSEE RD STE 105
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-5706
Practice Address - Country:US
Practice Address - Phone:321-512-9208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME127318207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine