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General NPI Number Information
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NPI Number | 1114180031
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Entity Type | Organization
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Legal Business Name | VANAJA SUREDDI MD PA
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Dates
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Enumeration Date | 07/10/2008
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Last Update Date | 12/15/2020
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Provider Practice Location Address
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Address Line | 3355 BURNS ROAD, SUITE - 103
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-4354
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Country | US
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Telephone | 561-622-0404
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Fax | 561-682-5963
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Provider Business Mailing Address
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Address Line | 3355 BURNS ROAD, SUITE - 103
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-4354
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Country | US
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Telephone | 561-622-0404
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Fax | 561-682-5963
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. VANAJA SUREDDI
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Credential | M.D.
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Telephone | 469-360-7334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME 75584
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License Number State | FL
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