Basic Information
| Provider Information | |||||||||
| NPI: | 1770837189 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KATHROTIYA | ||||||||
| FirstName: | PUJA | ||||||||
| MiddleName: | RAMJI | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 25487 | ||||||||
| Address2: | |||||||||
| City: | SARASOTA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342772487 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9412025342 | ||||||||
| FaxNumber: | 8552534836 | ||||||||
| Practice Location | |||||||||
| Address1: | 4351 CORTEZ RD W STE 101 | ||||||||
| Address2: | |||||||||
| City: | BRADENTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342103140 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9417550066 | ||||||||
| FaxNumber: | 9414876227 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2012 | ||||||||
| LastUpdateDate: | 11/30/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | TRN19154 | FL | N | Allopathic & Osteopathic Physicians | Dermatology | 207N00000X | ME124603 | FL | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.