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General NPI Number Information
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NPI Number | 1619075579
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Entity Type | Individual
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Provider Name | DURGA PRASAD MAGANTI M.D.,
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Gender | Male
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 2243 NORTH BLVD W
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City | DAVENPORT
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State | FL
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Zip | 33837-8990
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Country | US
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Telephone | 863-353-1394
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Fax | 863-638-5722
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Provider Business Mailing Address
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Address Line | 4354 DUCK DOWN LANE
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City | WINTER HAVEN
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State | FL
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Zip | 33884-3599
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Country | US
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Telephone | 863-353-1394
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Fax | 863-638-5722
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME96502
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | ME96502
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License Number State | FL
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