Basic Information
Provider Information
NPI: 1821006172
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TIRUMALASETTY
FirstName: SARASWATHI
MiddleName: B
NamePrefix: MS.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1965 CAPITAL CIR NE
Address2: STE 200
City: TALLAHASSEE
State: FL
PostalCode: 323088402
CountryCode: US
TelephoneNumber: 8506562006
FaxNumber: 8506562820
Practice Location
Address1: 960 LEARNING WAY
Address2:  
City: TALLAHASSEE
State: FL
PostalCode: 323064178
CountryCode: US
TelephoneNumber: 8506446230
FaxNumber: 8506444251
Other Information
ProviderEnumerationDate: 08/03/2006
LastUpdateDate: 04/04/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800XME49876FLY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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