Provider Demographics
NPI:1861521387
Name:ATUL KSHATRI MD PA
Entity type:Organization
Organization Name:ATUL KSHATRI MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ATUL
Authorized Official - Middle Name:
Authorized Official - Last Name:KSHATRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-415-3721
Mailing Address - Street 1:PO BOX 8370
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33775
Mailing Address - Country:US
Mailing Address - Phone:727-415-3721
Mailing Address - Fax:727-328-6230
Practice Address - Street 1:2323 9TH AVE N
Practice Address - Street 2:SUITE 200
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-6832
Practice Address - Country:US
Practice Address - Phone:727-415-3721
Practice Address - Fax:727-328-6230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0074913207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Not Answered208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty