Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | ME81827 | FL |
NPI | 1336180330 |
---|---|
Provider Name | Dr. Vijay Subba Reddy |
First Address | Orlando, FL 32804-4603 |
Second Address | Orlando, FL 32804-4603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 19/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
68943 | BCBS (01) | FL |
G88337 | (02) |