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NPI Code Detail

MEDICARE: DR. SIDDHARTHA ANNAMRAJU RAO M.D.

MEDICARE: DR. SIDDHARTHA ANNAMRAJU RAO 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
1207R00000XInternal Medicine Physician2004-00449NC
2207RC0000XCardiovascular Disease Physician200400449NC
3207RI0011XInterventional Cardiology Physician200400449NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22004-00449OTHERNCMEDICAL LICENSE #
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578644977
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SIDDHARTHA ANNAMRAJU RAO M.D.
Provider Business Mailing Address
First Line : 3001 PALM HARBOR BLVD STE A
Second Line :
City : PALM HARBOR
State : FL
Zip : 34683-1930
Country : US
Telephone Number : 727-474-0090
Fax Number : 727-474-0055
Provider Business Practice Location Address
First Line : 1000 CRESCENT GRN STE 102
Second Line :
City : CARY
State : NC
Zip : 27518-8117
Country : US
Telephone Number : 919-630-1226
Fax Number : 727-474-0055
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2006
Last Update Date : 04/14/2021

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