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Organization
SVETA MEDICAL PLLC
Active
Organization
SVETA MEDICAL PLLC
Active
Other names
Blossom Pediatric Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DURGA P CHINTAKAYALA M.D. (PHYSICIAN)
(813) 324-7029
Entity
Organization
Contact information
Practice address
507 E DR MARTIN LUTHER KING JR BLVD, 112, TAMPA, FL 33603-3932
(813) 229-6139
Mailing address
3301 BAYSHORE BLVD UNIT 2207B, TAMPA, FL 33629-8840
(718) 483-2934
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
261QP2300X
Primary Care Clinic/Center
ME112476
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014416300
—
FL
05
—
02625189
—
NY
01
—
456160000
PRI
NY
Enumeration date
07/25/2009
Last updated
12/22/2022
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