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NPI Code Detail

MEDICARE: MR. VENUGOPALA A REDDY MD

MEDICARE:  MR. VENUGOPALA A REDDY  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
1207R00000XInternal Medicine PhysicianME0042494FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CN2848OTHERFLRAILROAD MEDICARE GROUP
4110159321OTHERFLRAILROAD MEDICARE PIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
207316OTHERFLBCBS OF FLORIDA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194835975
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. VENUGOPALA A REDDY MD
Provider Business Mailing Address
First Line : 3400 N LECANTO HWY
Second Line : SUITE A
City : BEVERLY HILLS
State : FL
Zip : 34465-3548
Country : US
Telephone Number : 352-746-2227
Fax Number : 352-746-3587
Provider Business Practice Location Address
First Line : 3400 N LECANTO HWY
Second Line : SUITE A
City : BEVERLY HILLS
State : FL
Zip : 34465-3548
Country : US
Telephone Number : 352-746-2227
Fax Number : 352-746-3587
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 12/29/2014

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Directions to “ MR. VENUGOPALA A REDDY MD” Practice Location

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