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Individual

SRIDHAR PINNAMANENI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8136 CENTRALIA CT, STE 103, LEESBURG, FL 34788-3757
(352) 343-7246
(352) 259-8959
Mailing address
8136 CENTRALIA CT, STE 103, LEESBURG, FL 34788-3757
(352) 343-7246
(352) 259-8959

Taxonomy

Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
ME100408
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000553300
FL
01
47618
BCBS
FL
Enumeration date
05/15/2008
Last updated
03/05/2015
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