Individual
SUNIL MEDIDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 TAMPA GENERAL CIR, F170, TAMPA, FL 33606-3571
(813) 844-3397
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME122276
FL
208M00000X
Hospitalist Physician
Primary
ME122276
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015103400
—
FL
01
—
150N8
BLUE CROSS BLUE SHIELD
FL
Enumeration date
04/01/2012
Last updated
04/26/2021
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