Provider Demographics
NPI:1386750750
Name:RAU, SATHYA NARAYAN (MD)
Entity type:Individual
Prefix:
First Name:SATHYA
Middle Name:NARAYAN
Last Name:RAU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SATHYANARAYAN
Other - Middle Name:
Other - Last Name:RAU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:9406 BALM RIVERVIEW RD
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-5116
Mailing Address - Country:US
Mailing Address - Phone:813-236-9310
Mailing Address - Fax:813-236-9311
Practice Address - Street 1:9406 BALM RIVERVIEW RD
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-5116
Practice Address - Country:US
Practice Address - Phone:813-349-7800
Practice Address - Fax:813-349-7861
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88367208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL268156100Medicaid
FL268156100Medicaid
G44269Medicare UPIN