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NPI Code Detail

MEDICARE: TAKKALLAPELLI D RAO

MEDICARE: TAKKALLAPELLI D RAO
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
12084P0800XPsychiatry PhysicianME88674FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679552434
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAKKALLAPELLI D RAO
Provider Business Mailing Address
First Line : 200 AVENUE F NE
Second Line :
City : WINTER HAVEN
State : FL
Zip : 33881-4131
Country : US
Telephone Number : 863-297-1702
Fax Number : 863-291-6084
Provider Business Practice Location Address
First Line : 1201 1ST ST S
Second Line :
City : WINTER HAVEN
State : FL
Zip : 33880-3904
Country : US
Telephone Number : 863-297-1702
Fax Number : 863-291-6084
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2006
Last Update Date : 05/22/2013

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Directions to “ TAKKALLAPELLI D RAO ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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