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NPI Code Detail

MEDICARE: RITESH KORUMILLI M.D., M.P.H.

MEDICARE: RITESH KORUMILLI M.D., M.P.H.
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
12080P0203XPediatric Critical Care Medicine Physician20960NV
2390200000XStudent in an Organized Health Care Education/Training Program
3208000000XPediatrics Physician290068NY

General Provider Information

NPI Number : 1417335845
Entity Type Code : Individual
Provider Name (Legal Business Name) : RITESH KORUMILLI M.D., M.P.H.
Provider Business Mailing Address
First Line : 340 SE 3RD ST APT 3411
Second Line :
City : MIAMI
State : FL
Zip : 33131-1754
Country : US
Telephone Number : 914-356-1847
Fax Number :
Provider Business Practice Location Address
First Line : 3186 S MARYLAND PKWY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89109-2317
Country : US
Telephone Number : 702-961-5437
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2015
Last Update Date : 06/15/2026

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