Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | TRN9978 | FL |
NPI | 1043419799 |
---|---|
Provider Name | Chandana Reddy |
First Address | Tampa, FL 33606-3508 |
Second Address | Tampa, FL 33606-3508 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2007 |
Last Update Date | 13/07/2007 |