Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Manjul Derasari MD, PA

Organization Specialist · NPI 1407915929

Manjul Derasari MD, PA is a Specialist in Tampa, Florida. Licensed in Florida. Registered with an NPI since 2006.

Licensed in
FL
In the registry since
2006
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1912 E Busch Blvd
Tampa, FL 33612-8666
Phone: (813) 933-5900
Fax: (813) 935-9687
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence ME54111 (FL)

Record details

NPI number1407915929
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Manjul Derasari — Medical Director · (813) 933-5900
NPI enumeratedDecember 8, 2006
Last updated in NPPESDecember 19, 2013
Mailing address1912 E Busch Blvd, Tampa, FL 33612-8666

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