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Individual

DR. PURUSHOTTAM M REDDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
14134 NEPHRON LANE, HUDSON, FL 34667
(727) 863-5418
(727) 869-8626
Mailing address
14134 NEPHRONE LANE, RENAL HYPERTENSION CENTER, HUDSON, FL 34667
(727) 863-5418
(727) 869-8626

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
ME005664
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0004106456
AETNA
01
01245
UNIVERSAL
05
052954100
FL
01
09594
WELLCARE
01
1042
OPTIMUM
01
10501601
CITRUS HEALTH CARE
01
110069456
MEDICARE RR
01
210962
AV-MED
01
2217334
CIGNA
01
2504281
GHI
01
593068073
HUMANA MILITARY
01
933673
CCN
01
PRO127
QUALITY DELTA
Enumeration date
09/15/2005
Last updated
08/31/2010
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