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General NPI Number Information
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NPI Number | 1295763753
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Entity Type | Individual
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Provider Name | SUDHAKAR REDDY M.D
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Gender | Male
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 03/05/2024
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Provider Practice Location Address
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Address Line | 1330 BERDINGER AVE.
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City | ST. CLOUD
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State | FL
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Zip | 34769-4707
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Country | US
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Telephone | 407-891-2943
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Fax | 407-593-6854
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Provider Business Mailing Address
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Address Line | 1330 BERDINGER AVE.
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City | ST. CLOUD
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State | FL
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Zip | 34769-4707
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Country | US
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Telephone | 407-891-2943
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Fax | 407-593-6854
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME0040195
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME40195
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License Number State | FL
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