Provider Demographics
NPI:1265441091
Name:PANJIKARAN, ROSAMMA S (MD)
Entity type:Individual
Prefix:DR
First Name:ROSAMMA
Middle Name:S
Last Name:PANJIKARAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:350 MARY ST
Mailing Address - Street 2:SUITE G
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-4564
Mailing Address - Country:US
Mailing Address - Phone:941-505-0604
Mailing Address - Fax:941-505-4327
Practice Address - Street 1:350 MARY ST
Practice Address - Street 2:SUITE G
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-4564
Practice Address - Country:US
Practice Address - Phone:941-505-0604
Practice Address - Fax:941-505-4327
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0382352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD63913Medicare UPIN