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General NPI Number Information
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NPI Number | 1922100346
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Entity Type | Individual
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Provider Name | KOTESWARARAO VEMURI M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 960 58TH ST N
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City | ST PETERSBURG
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State | FL
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Zip | 33710-6325
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Country | US
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Telephone | 727-820-7778
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Fax | 727-820-7779
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Provider Business Mailing Address
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Address Line | 960 58TH ST N
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City | ST PETERSBURG
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State | FL
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Zip | 33710-6325
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Country | US
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Telephone | 727-820-7778
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Fax | 727-820-7779
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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 | 207RA0000X
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Taxonomy Name | Adolescent Medicine (Internal Medicine) Physician
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License Number | 4301071367
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License Number State | MI
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