Individual
VINOD R MIRYALA
Active
Individual
VINOD R MIRYALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME75516
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10715924
CAQH
FL
05
—
254028200
—
FL
01
—
269859500
MEDICAID GROUP
FL
01
—
43462
BCBS OF FL
FL
01
—
7390633
CIGNA
FL
01
—
77940
BCBS OF FL GROUP ID
FL
01
—
CF1416
MEDICARE RR GROUP
FL
01
—
ME75516
STATE MEDICAL LICENSE
FL
01
—
P00455415
MEDICARE RR
FL
Enumeration date
05/29/2007
Last updated
10/11/2023
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