MEDICARE: SRINIVASA R PALNATI MD PC

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

General Provider Information

NPI Number	:	1740373570
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SRINIVASA R PALNATI MD PC

Provider Business Mailing Address
First Line	:	13000 N 103RD AVE
Second Line	:	SUITE 59
City	:	SUN CITY
State	:	AZ
Zip	:	85351-3024
Country	:	US
Telephone Number	:	623-875-5460
Fax Number	:	623-972-3341

Provider Business Practice Location Address
First Line	:	13000 N 103RD AVE
Second Line	:	SUITE 59
City	:	SUN CITY
State	:	AZ
Zip	:	85351-3024
Country	:	US
Telephone Number	:	623-875-5460
Fax Number	:	623-972-3341

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SRINIVASA R PALNATI
Credential	:	MD
Telephone Number	:	623-875-5460

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	08/22/2020

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