Individual
VASUDEVA R BOMMINENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
685 PALM SPRINGS DR, SUITE 1B, ALTAMONTE SPRINGS, FL 32701-7853
(407) 339-4447
(407) 339-6649
Mailing address
807 S ORLANDO AVE, SUITE C, WINTER PARK, FL 32789-4870
(407) 894-4693
(407) 539-0469
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
ME0079940
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
269230
AVMED
FL
01
—
49866
BCBS
FL
01
—
P00184306
RAILROAD MEDICARE
FL
Enumeration date
08/24/2005
Last updated
02/22/2008
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