Provider Demographics
NPI:1366196800
Name:FLORIDA THERANOSTICS LLC
Entity type:Organization
Organization Name:FLORIDA THERANOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:
Authorized Official - Last Name:MUTHUKRISHNAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-719-7366
Mailing Address - Street 1:431 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-3103
Mailing Address - Country:US
Mailing Address - Phone:561-719-7366
Mailing Address - Fax:561-600-4476
Practice Address - Street 1:431 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-3103
Practice Address - Country:US
Practice Address - Phone:561-719-7366
Practice Address - Fax:561-600-4476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-03
Last Update Date:2025-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & TherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME154398OtherLICENSE BOARD