Individual
KIRAN KONDAVEETI TO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5 TAMPA GENERAL CIR, HMT 750, TAMPA, FL 33606-3360
(813) 844-3397
(813) 844-1934
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME 123059
FL
208M00000X
Hospitalist Physician
Primary
ME123059
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015103200
—
FL
01
—
150N6
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/29/2012
Last updated
04/26/2021
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