Healthcare Provider Details

I. General information

NPI: 1376038422
Provider Name (Legal Business Name): VIJAY SAI VEERAPANENI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2018
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40100 US-27
DAVENPORT FL
33837
US

IV. Provider business mailing address

9206 SAPPHIRE CREEK PL
TAMPA FL
33637-6600
US

V. Phone/Fax

Practice location:
  • Phone: 863-422-4971
  • Fax:
Mailing address:
  • Phone: 843-450-6611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301115889
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number85416
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: