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Individual

DR. INDI VASUDEVA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4218 W LINEBAUGH AVE, TAMPA, FL 33624-5241
(813) 961-6633
(813) 961-7733
Mailing address
4218 W LINEBAUGH AVE, TAMPA, FL 33624-5241
(813) 269-7555
(813) 269-7575

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
ME93153
FL
207RN0300X
Nephrology Physician
Primary
ME93153
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ME93153
FLORIDA MEDICAL LICENSE
FL
Enumeration date
06/24/2005
Last updated
10/16/2025
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