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Individual

SHRIKANTH UPADYA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1050 OLD CAMP RD, STE 270, THE VILLAGES, FL 32162-1762
(352) 633-1966
(352) 633-1969
Mailing address
1050 OLD CAMP RD 270, THE VILLAGES, FL 32162-1762
(352) 633-1966
(352) 633-1969

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
ME0096882
FL
207RI0011X
Interventional Cardiology Physician
Primary
ME96882
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11436483
CAQH
FL
01
1213382
CIGNA
FL
05
278696600
FL
01
91155
BCBS OF FL
FL
01
ME96882
STATE MEDICAL LICENSE
FL
01
P00384632
MEDICARE RR
FL
Enumeration date
08/31/2006
Last updated
07/31/2015
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