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General NPI Number Information
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NPI Number | 1497906093
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Entity Type | Individual
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Provider Name | SRUJANI GADDAM MD
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Gender | Female
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Dates
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Enumeration Date | 10/02/2008
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Last Update Date | 01/09/2024
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Provider Practice Location Address
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Address Line | 175 W PINE AVE
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City | LONGWOOD
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State | FL
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Zip | 32750-4168
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Country | US
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Telephone | 321-207-0172
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Fax | 321-201-0175
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Provider Business Mailing Address
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Address Line | PO BOX 616788
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City | ORLANDO
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State | FL
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Zip | 32861-6788
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Country | US
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Telephone | 407-533-6835
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Fax | 407-770-0661
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME125820
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME125820
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License Number State | FL
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