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Individual

ANNAPURNA PATTISAPU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
483 N SEMORAN BLVD STE 206, WINTER PARK, FL 32792-3800
(407) 678-2400
Mailing address
601 S HARBOUR ISLAND BLVD STE 200, TAMPA, FL 33602-5925
(727) 322-3439

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME0058005
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0576867005
FL
01
11569
BLUE CROSS & BLUE SHIELD
FL
01
4210891
AETNA
FL
Enumeration date
08/31/2006
Last updated
03/19/2026
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