Individual
DR. KOTESHWAR R TELUKUNTLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3630 MANATEE AVE W, STE B, BRADENTON, FL 34205-2557
(941) 792-1881
(941) 795-3924
Mailing address
PO BOX 102222, ATLANTA, GA 30368-2222
(239) 274-8200
(239) 278-3350
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
ME72534
FL
207RX0202X
Medical Oncology Physician
Primary
ME72534
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
259061100
—
FL
01
—
P00387326
RR MEDICARE
FL
Enumeration date
05/31/2005
Last updated
09/02/2022
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