Individual
DR. DEEPICA GANTA REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME95186
FL
208000000X
Pediatrics Physician
ME95186
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274831200
—
FL
01
—
P00790301
RAILROAD MEDICARE
FL
Enumeration date
02/07/2006
Last updated
10/30/2023
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