Individual
SUREKA BOLLEPALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12901 BRUCE B DOWNS BLVD, USF DIABETES CENTER, MDC 62, TAMPA, FL 33612-4742
(813) 396-2580
Mailing address
PO BOX 917770, ORLANDO, FL 32891-7770
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
ME 106517
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002214100
—
FL
01
—
149KF
BLUE CROSS BLUE SHIELD
FL
Enumeration date
05/17/2007
Last updated
08/27/2010
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