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1225024730

NPI Code Detail

MEDICARE: DR. PRASAD R SIRIPURAPU MD

MEDICARE: DR. PRASAD R SIRIPURAPU 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	ME153379	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	ME153379	OTHER	FL	STATE LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225024730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PRASAD R SIRIPURAPU MD

Provider Business Mailing Address
First Line	:	8800 S OCEAN DR APT 910
Second Line	:
City	:	JENSEN BEACH
State	:	FL
Zip	:	34957-2147
Country	:	US
Telephone Number	:	740-632-2024
Fax Number	:

Provider Business Practice Location Address
First Line	:	1545 9TH ST SW
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32962-4312
Country	:	US
Telephone Number	:	772-257-8224
Fax Number	:	772-213-3157

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

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	04/04/2022

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Directions to “ DR. PRASAD R SIRIPURAPU MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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