Healthcare Provider Details

I. General information

NPI: 1083292536
Provider Name (Legal Business Name): SASWATHA ANIREDDY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1855 VETERANS PARK DR STE 201
NAPLES FL
34109-0446
US

IV. Provider business mailing address

1855 VETERANS PARK DR STE 201
NAPLES FL
34109-0446
US

V. Phone/Fax

Practice location:
  • Phone: 239-260-1033
  • Fax: 239-260-1491
Mailing address:
  • Phone: 239-260-1033
  • Fax: 239-260-1491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number20A23544
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: