MEDICARE: DR. LINGA VINAY REDDY M.D., PH. 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
1	2084N0400X	Neurology Physician	ME122985	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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558412528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINGA VINAY REDDY M.D., PH. D.

Provider Business Mailing Address
First Line	:	9960 NW 116TH WAY STE 13
Second Line	:
City	:	MEDLEY
State	:	FL
Zip	:	33178-1175
Country	:	US
Telephone Number	:	786-924-1311
Fax Number	:	786-924-1313

Provider Business Practice Location Address
First Line	:	2919 W SWANN AVE STE 401
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-4083
Country	:	US
Telephone Number	:	813-872-1548
Fax Number	:	813-872-7509

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

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	03/24/2021

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