Healthcare Provider Details

I. General information

NPI: 1497489736
Provider Name (Legal Business Name): CHAITHANYA REDDY BANDI V
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2022
Last Update Date: 12/07/2025
Certification Date: 12/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 MCGREGOR AVE APT 10B
CINCINNATI OH
45219-2964
US

IV. Provider business mailing address

PO BOX 917770
ORLANDO FL
32891-0001
US

V. Phone/Fax

Practice location:
  • Phone: 919-909-8252
  • Fax:
Mailing address:
  • Phone: 813-821-8038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License NumberME173558
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: