Individual
SUSHMA KONERU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1723 LUCERNE TER STE 100, ORLANDO, FL 32806-2916
(407) 738-4200
Mailing address
1723 LUCERNE TER STE 100, ORLANDO, FL 32806-2916
(407) 738-4200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125-050062
IL
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
Primary
ME131009
FL
207RC0000X
Cardiovascular Disease Physician
26298
IA
207RC0000X
Cardiovascular Disease Physician
ME131009
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020180500
—
FL
05
—
036120390
—
IL
05
—
1457572547
—
IA
01
—
P01372068
RR MEDICARE
IA
Enumeration date
05/02/2007
Last updated
11/28/2023
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