Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | DN 16053 | FL |
Y | 213EG0000X | General Practice | DN 16053 | FL |
NPI | 1003939489 |
---|---|
Provider Name | Dr. Anitha Reddy |
First Address | Lake Worth, FL 33467-8726 |
Second Address | Greenacres, FL 33463-4727 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2007 |
Last Update Date | 08/07/2007 |