Individual
DR. SIVA SURYADEVARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
205 ZEAGLER DR STE 101, PALATKA, FL 32177-3860
(386) 325-2836
(386) 326-2736
Mailing address
PO BOX 919932, ORLANDO, FL 32891-9932
(904) 493-3333
(904) 493-2222
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
ME116319
FL
207RI0011X
Interventional Cardiology Physician
13556
WI
207RI0011X
Interventional Cardiology Physician
ME 116319
FL
207RI0011X
Interventional Cardiology Physician
Primary
ME116319
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003135084A
—
GA
05
—
008906600
—
FL
01
—
14Q8K
BCBS
FL
Enumeration date
01/23/2007
Last updated
01/26/2026
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