Healthcare Provider Details

I. General information

NPI: 1699238030
Provider Name (Legal Business Name): NITHIN RAO VENEPALLY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2019
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38035 MEDICAL CENTER AVE
ZEPHYRHILLS FL
33540-1384
US

IV. Provider business mailing address

38035 MEDICAL CENTER AVE
ZEPHYRHILLS FL
33540-1384
US

V. Phone/Fax

Practice location:
  • Phone: 813-788-1400
  • Fax: 813-788-7691
Mailing address:
  • Phone: 813-788-1400
  • Fax: 813-788-7691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberME180575
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: