Healthcare Provider Details

I. General information

NPI: 1316755754
Provider Name (Legal Business Name): NEEHARIKA HEPHZI KATRAGADDA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2024
Last Update Date: 09/27/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11241 MIROMAR SQUARE BLVD
ESTERO FL
33928-6229
US

IV. Provider business mailing address

512 SAGAMORE PKWY W
WEST LAFAYETTE IN
47906-1458
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax:
Mailing address:
  • Phone: 765-497-3551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11045258
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71016096A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: