Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | ME85266 | FL |
NPI | 1023010808 |
---|---|
Provider Name | Giridhar S Talluri |
First Address | Aventura, FL 33180-1252 |
Second Address | Aventura, FL 33180-1252 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2005 |
Last Update Date | 10/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
190236 | AMERIGROUP (01) | FL |
288172 | AVMED (01) | FL |
34506 | BCBS (01) | FL |
3980742 | CIGNA (01) | FL |
43118 | NHP (01) | FL |
7746438 | AETNA (01) | FL |
H65077 | (02) | FL |
H65077 | VISTA (01) | FL |
P00301349 | RAILROAD MEDICARE (01) | FL |