Healthcare Provider Details

I. General information

NPI: 1437274701
Provider Name (Legal Business Name): SAMRIDHI NARULA NALLAMSHETTY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SAMRIDHI NARULA M.D.

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 08/30/2021
Certification Date: 08/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2352 BRUCE B DOWNS BLVD STE 303
WESLEY CHAPEL FL
33544-9203
US

IV. Provider business mailing address

38135 MARKET SQ
ZEPHYRHILLS FL
33542-7505
US

V. Phone/Fax

Practice location:
  • Phone: 813-388-6855
  • Fax: 813-355-5894
Mailing address:
  • Phone: 813-528-4975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberME101592
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207KI0005X
TaxonomyClinical & Laboratory Immunology (Allergy & Immunology) Physician
License NumberME101592
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME101592
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License NumberME101592
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberME101592
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: