MEDICARE: PRASAD.A.IRAGAVARAPU, M.D, P.A

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	0039794	FL

General Provider Information

NPI Number	:	1679506885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRASAD.A.IRAGAVARAPU, M.D, P.A

Provider Business Mailing Address
First Line	:	6670 NEWPORT LAKE CIR
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33496-3001
Country	:	US
Telephone Number	:	561-997-8531
Fax Number	:

Provider Business Practice Location Address
First Line	:	6670 NEWPORT LAKE CIR
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33496-3001
Country	:	US
Telephone Number	:	561-997-8531
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PRASAD ACHYUTA IRAGAVARAPU
Credential	:	M.D
Telephone Number	:	561-997-8531

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	01/26/2010

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