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Individual
VASUDEVA R BOMMINENI
Active
Individual
VASUDEVA R BOMMINENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
ME0079940
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
269230
AVMED
FL
01
—
49866
BCBS
FL
01
—
P00184306
RAILROAD MEDICARE
FL
Enumeration date
08/24/2005
Last updated
02/22/2008
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