Healthcare Provider Details

I. General information

NPI: 1447601653
Provider Name (Legal Business Name): SHARON RACHAPUDI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2016
Last Update Date: 12/27/2021
Certification Date: 12/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8702 HUNTERS LAKE DR STE 100
TAMPA FL
33647-2855
US

IV. Provider business mailing address

8702 HUNTERS LAKE DR STE 100
TAMPA FL
33647-2855
US

V. Phone/Fax

Practice location:
  • Phone: 813-467-4700
  • Fax: 813-467-4261
Mailing address:
  • Phone: 813-467-4700
  • Fax: 813-467-4261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2019-01783
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME150634
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: