Provider Demographics
NPI:1528102936
Name:SATIJA, ASHOK KUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:ASHOK
Middle Name:KUMAR
Last Name:SATIJA
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 1:1599 NW 9TH AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-1310
Mailing Address - Country:US
Mailing Address - Phone:561-392-6666
Mailing Address - Fax:561-392-1583
Practice Address - Street 1:1599 NW 9TH AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-1310
Practice Address - Country:US
Practice Address - Phone:561-392-6666
Practice Address - Fax:561-392-1583
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL42340207R00000X
AZ11085207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL42340OtherMEDICAL LICENSE NUMBER
FLA64025Medicare UPIN
FL73258Medicare ID - Type Unspecified