MEDICARE: SHUBHA KOLLAMPARE 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
1	207RR0500X	Rheumatology Physician	ME153239	FL

General Provider Information

NPI Number	:	1902154859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHUBHA KOLLAMPARE MD

Provider Business Mailing Address
First Line	:	2105 HARTWOOD MARSH RD STE 3
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-5390
Country	:	US
Telephone Number	:	352-810-9073
Fax Number	:	352-810-9082

Provider Business Practice Location Address
First Line	:	2105 HARTWOOD MARSH RD STE 3
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-5390
Country	:	US
Telephone Number	:	347-216-5347
Fax Number	:

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

Provider Enumeration Date	:	08/27/2012
Last Update Date	:	12/17/2025

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