Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | ME50728 | FL |
Y | 111NI0900X | Internist | ME50728 | FL |
N | 207RA0401X | Internist - Addiction Medicine | ME50728 | FL |
N | 207RC0000X | Internist - Cardiovascular Disease | ME50728 | FL |
NPI | 1083675755 |
---|---|
Provider Name | Dr. Rao Rama Gudapati |
First Address | Tampa, FL 33626-2680 |
Second Address | Tampa, FL 33612-8502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2006 |
Last Update Date | 17/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B18463 | (02) | FL |
ME50728 | FLORIDA LICENSE NUMBER (01) | FL |