Organization
SRIDHARA SASTRY MD PA
Active
Other names
PEDIATRIC CRITICAL CARE ASSOCIATES
Organization subpart
No
Provider details
NPI number
Authorized official
SRIDHARA SASTRY MD (OWNER / PROVIDER)
(813) 855-7884
Entity
Organization
Contact information
Practice address
5003 E LONGBOAT BLVD, TAMPA, FL 33615-4229
(813) 855-7884
Mailing address
PO BOX 21727, TAMPA, FL 33622-1727
(727) 823-2188
(727) 823-9502
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
045861900
—
FL
Enumeration date
09/06/2006
Last updated
10/08/2012
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