Individual
DR. SIVA S. GUMMADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2105 SW 20TH PL, OCALA, FL 34471-7734
(352) 622-4251
(352) 622-0102
Mailing address
2111 SW 20TH PL, OCALA, FL 34471-7734
(352) 622-4251
(352) 622-0102
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
ME72590
FL
207RI0011X
Interventional Cardiology Physician
Primary
ME72590
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
253395200
—
FL
01
—
45041
BCBS
FL
01
—
P00209067
RAILROAD MEDICARE
FL
Enumeration date
06/25/2006
Last updated
03/17/2016
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