Provider Demographics
NPI:1194382697
Name:SUNKARANENI, SUSHANT (MD)
Entity type:Individual
Prefix:DR
First Name:SUSHANT
Middle Name:
Last Name:SUNKARANENI
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 1:1011 E CUMBERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-4245
Mailing Address - Country:US
Mailing Address - Phone:732-947-1462
Mailing Address - Fax:
Practice Address - Street 1:1011 E CUMBERLAND AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-4245
Practice Address - Country:US
Practice Address - Phone:732-947-1462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-21
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME162525207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty