Healthcare Provider Details

I. General information

NPI: 1295883841
Provider Name (Legal Business Name): MURTHY RAVIPATI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4504 WISHART PL
TAMPA FL
33603-2724
US

IV. Provider business mailing address

4504 WISHART PL
TAMPA FL
33603-2724
US

V. Phone/Fax

Practice location:
  • Phone: 813-605-7775
  • Fax:
Mailing address:
  • Phone: 813-605-7775
  • Fax: 813-605-7160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME54579
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: