Individual
GEETHA GANTI VEDULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1776 N PINE ISLAND RD STE 214, PLANTATION, FL 33322
(310) 206-1166
(310) 301-8713
Mailing address
1776 N PINE ISLAND RD STE 214, PLANTATION, FL 33322-5223
(954) 452-9922
(954) 452-7574
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
A108911
CA
207W00000X
Ophthalmology Physician
Primary
ME107675
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003568900
—
FL
05
—
00A1089110
—
CA
Enumeration date
07/02/2008
Last updated
04/14/2021
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