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NPI Code Detail

MEDICARE: VENKATA R. YERRAMILLI M.D.

MEDICARE: VENKATA R. YERRAMILLI M.D.
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
1207Q00000XFamily Medicine PhysicianME109954FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
114CR6OTHERFLBCBS
2EZ010XOTHERFLBCBS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346203775
Entity Type Code : Individual
Provider Name (Legal Business Name) : VENKATA R. YERRAMILLI M.D.
Provider Business Mailing Address
First Line : 3302 BONITA BEACH RD
Second Line : #170
City : BONITA SPRINGS
State : FL
Zip : 34134-4216
Country : US
Telephone Number : 239-624-1050
Fax Number : 239-624-1051
Provider Business Practice Location Address
First Line : 3302 BONITA BEACH RD STE 170
Second Line :
City : BONITA SPRINGS
State : FL
Zip : 34134-4217
Country : US
Telephone Number : 239-624-1050
Fax Number : 239-624-1051
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2006
Last Update Date : 07/21/2022

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Directions to “ VENKATA R. YERRAMILLI M.D.” Practice Location

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