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NPI Code Detail

MEDICARE: MR. SIVA KUMAR MARREDDI PHARMACIST

MEDICARE:  MR. SIVA KUMAR MARREDDI  PHARMACIST
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
1183500000XPharmacistPS36510FL

General Provider Information

NPI Number : 1124303615
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SIVA KUMAR MARREDDI PHARMACIST
Provider Business Mailing Address
First Line : 11079 S MILITARY TRL
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33436-7218
Country : US
Telephone Number : 561-736-2998
Fax Number :
Provider Business Practice Location Address
First Line : 11079 S MILITARY TRL
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33436-7218
Country : US
Telephone Number : 561-736-2998
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2011
Last Update Date : 12/16/2011

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Directions to “ MR. SIVA KUMAR MARREDDI PHARMACIST” Practice Location

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