Healthcare Provider Details

I. General information

NPI: 1922785419
Provider Name (Legal Business Name): SRS HEALTHCARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2023
Last Update Date: 01/06/2025
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2943 ALLEGRA WAY
LUTZ FL
33559-6998
US

IV. Provider business mailing address

2949 ALLEGRA WAY
LUTZ FL
33559
US

V. Phone/Fax

Practice location:
  • Phone: 813-922-1525
  • Fax:
Mailing address:
  • Phone: 813-922-1525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: VENKATESWARLU MUVVA
Title or Position: OWNER
Credential:
Phone: 813-922-1525