Individual
PRUDHVI RAJAN KARUMANCHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., M.P.H.
Contact information
Practice address
3001 W. DR. MARTIN LUTHER KING JR. BLVD, 3 EAST, TAMPA, FL 33607
(813) 337-7535
Mailing address
3001 W DR. MARTIN LUTHER KING JR. BLVD 3 EAST, TAMPA, FL 33607
(813) 337-7535
(785) 354-6349
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
ME126502
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018568200
—
FL
01
—
036126553
STATE MEDICAL BOARD
IL
01
—
068002136
MEDICARE PTAN
KS
01
—
125050813
PHYSICIAN TEMPORARY LICEN
IL
05
—
200738900A
—
KS
01
—
511630601949-003
MEDICARE
FL
01
—
ME126502
STATE MEDICAL BOARD
FL
Enumeration date
03/04/2008
Last updated
04/01/2024
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