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Individual

DR. NANDHEESHA HANUMANTHAPPA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3221 TAMIAMI TRL, PORT CHARLOTTE, FL 33952-8002
(941) 505-8720
(941) 505-8747
Mailing address
3221 TAMIAMI TRL, PORT CHARLOTTE, FL 33952-8002
(941) 505-8720
(941) 505-8747

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
ME116075
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14R6Z
BCFL
FL
01
P01197128
RR MEDICARE
FL
Enumeration date
05/27/2010
Last updated
09/05/2013
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