MEDICARE: SRINIVAS KAZA 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	208600000X	Surgery Physician	ME97552	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	:	1750311551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SRINIVAS KAZA MD

Provider Business Mailing Address
First Line	:	2326 S CONGRESS AVE STE 2D
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-7614
Country	:	US
Telephone Number	:	561-801-1223
Fax Number	:	561-828-3974

Provider Business Practice Location Address
First Line	:	142 JOHN F KENNEDY DR
Second Line	:
City	:	ATLANTIS
State	:	FL
Zip	:	33462-1159
Country	:	US
Telephone Number	:	561-439-1500
Fax Number	:	561-439-9902

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

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	12/18/2019

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Directions to “ SRINIVAS KAZA MD” Practice Location

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