MEDICARE: DR. JOGI R. NAREDDY M.D.

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
1	207RC0000X	Cardiovascular Disease Physician	ME 40160	FL

General Provider Information

NPI Number	:	1114918125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOGI R. NAREDDY M.D.

Provider Business Mailing Address
First Line	:	14100 FIVAY RD.
Second Line	:	SUITE 160
City	:	HUDSON
State	:	FL
Zip	:	34667-7194
Country	:	US
Telephone Number	:	727-862-1080
Fax Number	:	727-863-3093

Provider Business Practice Location Address
First Line	:	14100 FIVAY RD.
Second Line	:	SUITE 160
City	:	HUDSON
State	:	FL
Zip	:	34667-7194
Country	:	US
Telephone Number	:	727-862-1080
Fax Number	:	727-863-3093

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	07/09/2007

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