Individual
SRIDHARA SASTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5003 E LONGBOAT BLVD, TAMPA, FL 33615-4229
(813) 855-7884
(813) 854-4132
Mailing address
PO BOX 21727, TAMPA, FL 33622-1727
(727) 823-2188
(727) 828-0723
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
ME46263
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03864
BCBS OF FL
FL
05
—
045861900
—
FL
Enumeration date
09/06/2006
Last updated
10/15/2009
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