MEDICARE: SANDHYA KOLAGATLA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	59994	KY
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1184294084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDHYA KOLAGATLA MD

Provider Business Mailing Address
First Line	:	6101 BLUE LAGOON DR STE 200
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3168
Country	:	US
Telephone Number	:	859-334-1550
Fax Number	:	877-687-5190

Provider Business Practice Location Address
First Line	:	171 W LOWRY LN STE 180
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40503-3006
Country	:	US
Telephone Number	:	859-334-1550
Fax Number	:	877-687-5190

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2021
Last Update Date	:	02/12/2026

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