Provider Demographics
NPI:1215937560
Name:IYER, HARI V (MD)
Entity type:Individual
Prefix:
First Name:HARI
Middle Name:V
Last Name:IYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:HARIHARASUBRAMANIAN
Other - Middle Name:V
Other - Last Name:IYER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 3089
Mailing Address - Street 2:
Mailing Address - City:HOMOSASSA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34447-3089
Mailing Address - Country:US
Mailing Address - Phone:352-628-7672
Mailing Address - Fax:352-628-5190
Practice Address - Street 1:3475 S SUNCOAST BLVD
Practice Address - Street 2:
Practice Address - City:HOMOSASSA
Practice Address - State:FL
Practice Address - Zip Code:34448-2322
Practice Address - Country:US
Practice Address - Phone:352-628-7672
Practice Address - Fax:352-628-5190
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2013-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0044371208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL048855100Medicaid
FL09070OtherBLUE SHIELD FLORIDA
FL110023029OtherRAILROAD MEDICARE
FL09070OtherBLUE SHIELD HEALTH OPTION
FL217649OtherAVMED HEALTH PLAN
FL048855100Medicaid
FL09070Medicare PIN