MEDICARE: DR. VIJAYAKRISHNA GADIYARAM 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	207RH0003X	Hematology & Oncology Physician	ME114800	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01201694	OTHER	FL	RAILROAD MEDICARE PROVIDER NUMBER

Other Identifiers

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

General Provider Information

NPI Number	:	1336341668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VIJAYAKRISHNA GADIYARAM M.D.

Provider Business Mailing Address
First Line	:	400 PINELLAS ST STE 220
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33756-3318
Country	:	US
Telephone Number	:	727-462-3692
Fax Number	:	727-266-4935

Provider Business Practice Location Address
First Line	:	400 PINELLAS ST STE 220
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33756-3318
Country	:	US
Telephone Number	:	727-462-3692
Fax Number	:	727-266-4935

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

Provider Enumeration Date	:	05/31/2007
Last Update Date	:	08/15/2022

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