Provider Demographics
NPI:1396309217
Name:CHANDRAN, ARATHY SURESH (MD)
Entity type:Individual
Prefix:MRS
First Name:ARATHY
Middle Name:SURESH
Last Name:CHANDRAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:ARATHY
Other - Middle Name:SURESH
Other - Last Name:MANNATHAZHATHU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8529 PINES BLVD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6611
Mailing Address - Country:US
Mailing Address - Phone:954-704-3300
Mailing Address - Fax:
Practice Address - Street 1:8529 PINES BLVD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6611
Practice Address - Country:US
Practice Address - Phone:954-704-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-25
Last Update Date:2022-08-16
Deactivation Date:2019-12-09
Deactivation Code:
Reactivation Date:2020-01-13
Provider Licenses
StateLicense IDTaxonomies
FLME157247207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine