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NPI Code Detail

MEDICARE: SANJAY SARADHI BOMMAKANTI MD

MEDICARE: SANJAY SARADHI BOMMAKANTI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician37252AZ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00628928OTHERAZMEDICARE RAILROAD#

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114111002
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANJAY SARADHI BOMMAKANTI MD
Provider Business Mailing Address
First Line : 6101 BLUE LAGOON DR STE 200
Second Line :
City : MIAMI
State : FL
Zip : 33126-3168
Country : US
Telephone Number : 305-500-2000
Fax Number :
Provider Business Practice Location Address
First Line : 14273 W GRAND AVE STE 100
Second Line :
City : SURPRISE
State : AZ
Zip : 85374-4361
Country : US
Telephone Number : 623-428-8189
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2007
Last Update Date : 08/11/2025

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Directions to “ SANJAY SARADHI BOMMAKANTI MD” Practice Location

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