Individual
DR. KOUSHIK RAVI REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2 TAMPA GENERAL CIR, TAMPA, FL 33606-3571
(813) 821-8038
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
226094-1
NY
207R00000X
Internal Medicine Physician
ME 97970
FL
207RC0000X
Cardiovascular Disease Physician
226094-1
NY
207RC0000X
Cardiovascular Disease Physician
Primary
ME 97970
FL
207RI0011X
Interventional Cardiology Physician
226094-1
NY
207RI0011X
Interventional Cardiology Physician
ME 97970
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16015
BCBS
FL
05
—
278304500
—
FL
Enumeration date
03/30/2007
Last updated
12/02/2022
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