Individual
DR. SRINIVAS TUMMALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3 SW 129TH AVE STE 101-102, PEMBROKE PINES, FL 33027-1775
(954) 852-3831
(954) 852-3832
Mailing address
5846 S FLAMINGO RD STE 315, COOPER CITY, FL 33330-3237
(954) 852-3831
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
0077596
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113404800
—
FL
05
—
116768500
—
FL
Enumeration date
12/09/2005
Last updated
05/07/2024
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