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Individual

SAGARIKA NALLU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
13101 BRUCE B DOWNS BLVD, MDC105, TAMPA, FL 33612-3803
(813) 259-8700
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-2201
(813) 974-2812

Taxonomy

Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
250077
NY
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
ME113018
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
016414800
FL
01
9XISC
BLUE CROSS BLUE SHIELD
FL
Enumeration date
09/29/2008
Last updated
10/27/2020
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