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General NPI Number Information
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NPI Number | 1891679486
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Entity Type | Organization
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Legal Business Name | RADIANT RHEUMATOLOGY LLC
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 2105 HARTWOOD MARSH RD STE 3
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City | CLERMONT
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State | FL
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Zip | 34711-5390
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Country | US
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Telephone | 347-216-5347
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Fax |
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Provider Business Mailing Address
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Address Line | 11538 DELWICK DR
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City | WINDERMERE
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State | FL
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Zip | 34786-6073
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Country | US
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Telephone | 347-216-5347
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHUBHA KOLLAMPARE
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Credential | MD
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Telephone | 352-810-9073
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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