Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | ME74348 | FL |
NPI | 1033165964 |
---|---|
Provider Name | Dr. Kalyani Gaddipati |
First Address | Lake Mary, FL 32746-4802 |
Second Address | Lake Mary, FL 32746-4802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2006 |
Last Update Date | 05/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100016196 | RAILROAD MEDICARE (01) | |
254587000 | (05) | FL |
2745785 | AETNA (01) | |
3542 | FHHS (01) | |
43554 | BCBS (01) | |
5702044007 | CIGNA (01) | |
G69697 | (02) |