Healthcare Provider Details

I. General information

NPI: 1073122347
Provider Name (Legal Business Name): HEMANTHI VELIGARAM MBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2020
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1295 W FAIRFIELD DR
PENSACOLA FL
32501-1107
US

IV. Provider business mailing address

800 ROSE ST #101 (HQ)
LEXINGTON KY
40536-7001
US

V. Phone/Fax

Practice location:
  • Phone: 850-941-7842
  • Fax: 850-332-0155
Mailing address:
  • Phone: 850-960-5149
  • Fax: 850-332-0155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number04-52444
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberTRN31942
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: