Individual
PAVAN KUMAR TENNETI VENKATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13041 N DEL WEBB BLVD, SUITE 200, SUN CITY, AZ 85351
(623) 832-0300
(623) 285-2801
Mailing address
13041 N DEL WEBB BLVD, SUITE 200, SUN CITY, AZ 85351
(623) 832-0300
(623) 285-2801
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2019-00568
NC
207RH0003X
Hematology & Oncology Physician
Primary
49297
AZ
207RH0003X
Hematology & Oncology Physician
ME156097
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114898300
—
FL
01
—
GIVED
FL BLUE
FL
01
—
PK944
MEDICARE
FL
Enumeration date
07/12/2011
Last updated
08/14/2025
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