Individual
PRANAV REDDY BOMMINENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1 SHIRCLIFF WAY, JACKSONVILLE, FL 32204-4748
(904) 308-7000
Mailing address
1601 CUMMINS DR STE D, MODESTO, CA 95358-6411
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
UO8649
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2022
Last updated
06/24/2026
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