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Individual

GIRIDHAR S TALLURI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
21110 BISCAYNE BLVD STE 403, AVENTURA, FL 33180-1252
(305) 918-0742
(305) 918-0787
Mailing address
21110 BISCAYNE BLVD STE 403, AVENTURA, FL 33180-1252
(305) 918-0742
(305) 918-0787

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME85266
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
007325500
FL
01
190236
AMERIGROUP
FL
01
288172
AVMED
FL
01
34506
BCBS
FL
01
3980742
CIGNA
FL
01
43118
NHP
FL
01
7746438
AETNA
FL
01
H65077
VISTA
FL
01
P00301349
RAILROAD MEDICARE
FL
Enumeration date
08/11/2005
Last updated
05/18/2023
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