Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | ME101592 | FL |
N | 207KA0200X | Allergist | ME101592 | FL |
N | 207R00000X | Internist | ME101592 | FL |
N | 111NI0900X | Internist | ME101592 | FL |
N | 207RA0201X | Internist - Allergy & Immunology | ME101592 | FL |
NPI | 1437274701 |
---|---|
Provider Name | Dr. Samridhi Narula Nallamshetty |
First Address | Zephyrhills, FL 33542-7505 |
Second Address | Wesley Chapel, FL 33544-9203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 30/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000305500 | (05) | FL |
P01148875 | R&R MEDICARE (01) | FL |