MEDICARE: DR. RAVI PRASAD AKELLA 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
1	207R00000X	Internal Medicine Physician	ME0074539	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

General Provider Information

NPI Number	:	1568405272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAVI PRASAD AKELLA M.D.

Provider Business Mailing Address
First Line	:	1507 S HIAWASSEE RD
Second Line	:	SUITE 107
City	:	ORLANDO
State	:	FL
Zip	:	32835-5718
Country	:	US
Telephone Number	:	407-445-9545
Fax Number	:	407-445-9365

Provider Business Practice Location Address
First Line	:	1507 S HIAWASSEE RD
Second Line	:	SUITE 107
City	:	ORLANDO
State	:	FL
Zip	:	32835-6438
Country	:	US
Telephone Number	:	407-445-9545
Fax Number	:	407-445-9365

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

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	10/07/2011

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