MEDICARE: V RAO EMANDI MD PA

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	174400000X	Specialist	ME36725	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	:	1932465317
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	V RAO EMANDI MD PA

Provider Business Mailing Address
First Line	:	13904 LAKESHORE BLVD
Second Line	:	#410
City	:	HUDSON
State	:	FL
Zip	:	34667-1481
Country	:	US
Telephone Number	:	727-862-5489
Fax Number	:	727-862-0397

Provider Business Practice Location Address
First Line	:	5802 STATE ROAD 54
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-6050
Country	:	US
Telephone Number	:	727-842-2795
Fax Number	:	727-842-8676

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. MARC PANARISI
Credential	:
Telephone Number	:	727-862-7103

Provider Enumeration Date	:	04/10/2012
Last Update Date	:	04/10/2012

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