Individual
DR. VENKATA R. REDDIVARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2810 W SAINT ISABEL ST, SUITE 101, TAMPA, FL 33607-6375
(813) 873-7479
Mailing address
PO BOX 14657, CLEARWATER, FL 33766-4657
(727) 797-6768
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
ME116695
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009448300
—
FL
Enumeration date
08/22/2007
Last updated
04/14/2015
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