Individual
MR. VENKATA RAO EMANDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14535 CORTEZ BLVD, BROOKSVILLE, FL 34613
(352) 596-3622
(352) 596-0901
Mailing address
14690 SPRING HILL DR STE 101, SPRING HILL, FL 34609-8102
(352) 799-0046
(352) 606-2857
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
ME0040043
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08116
BLUE CROSS BLUE SHIELD
FL
05
—
372038100
—
FL
Enumeration date
08/22/2005
Last updated
07/11/2018
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