MEDICARE: SHANMUGAPRIYA REDDY MD

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	207RR0500X	Rheumatology Physician	ME96110	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	90978	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710039045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANMUGAPRIYA REDDY MD

Provider Business Mailing Address
First Line	:	PO BOX 2779
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33568-2779
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11952 BOYETTE RD
Second Line	:	SOUTHWEST FLORIDA RHEUMATOLOGY
City	:	RIVERVIEW
State	:	FL
Zip	:	33569-5601
Country	:	US
Telephone Number	:	813-672-2243
Fax Number	:	813-672-2245

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

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	01/30/2025

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