Individual
DR. VIKRANTH REDDY GONGIDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
787 37TH ST STE 250, VERO BEACH, FL 32960-7305
(772) 494-0794
(772) 494-0745
Mailing address
787 37TH ST STE 250, VERO BEACH, FL 32960-7305
(772) 494-0794
(772) 494-0745
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5101016957
MI
207RC0000X
Cardiovascular Disease Physician
MB08595000
NJ
207RC0000X
Cardiovascular Disease Physician
Primary
OS11675
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005437700
—
FL
01
—
14L1Y
BCBS
FL
Enumeration date
05/02/2007
Last updated
11/01/2023
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