Individual
PRAKASH V REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
140 6TH AVE, INDIALANTIC, FL 32903-3204
(321) 312-3501
(321) 723-9176
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
ME83944
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272481200
—
FL
01
—
64150X
MEDICARE
FL
Enumeration date
12/07/2005
Last updated
05/04/2022
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