Healthcare Provider Details

I. General information

NPI: 1407763634
Provider Name (Legal Business Name): ZENA JUILA REDDY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E ROLLINS ST
ORLANDO FL
32803-1248
US

IV. Provider business mailing address

2405 BERKSHIRE CT
KISSIMMEE FL
34746-5421
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-8158
  • Fax:
Mailing address:
  • Phone: 407-973-6230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: