Individual
AVDESH R BURAGADDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 N LAKEMONT AVE, WINTER PARK, FL 32792-3273
(407) 646-7812
(407) 303-0475
Mailing address
200 N LAKEMONT AVE, WINTER PARK, FL 32792-3273
(407) 646-7812
(407) 303-0475
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME167601
FL
208000000X
Pediatrics Physician
4301090536
MI
208M00000X
Hospitalist Physician
27298
NE
208M00000X
Hospitalist Physician
MD-43105
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
098611129
MEDICARE PTAN
NE
Enumeration date
07/23/2007
Last updated
08/14/2024
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