Individual
SIREESHA DATLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
725 6TH AVE S STE 2200, ST PETERSBURG, FL 33701-4553
(727) 821-0017
(727) 822-7473
Mailing address
PO BOX 102222, ATLANTA, GA 30368-2222
(239) 274-8200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
263027
NY
207RH0000X
Hematology (Internal Medicine) Physician
ME161713
FL
207RH0003X
Hematology & Oncology Physician
57785
AZ
207RX0202X
Medical Oncology Physician
Primary
ME161713
FL
390200000X
Student in an Organized Health Care Education/Training Program
263027
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118166200
—
FL
Enumeration date
11/01/2011
Last updated
01/08/2026
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