Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | A103967 | CA |
Y | 204F00000X | Transplant Surgeon | ME136464 | FL |
N | 208200000X | Surgeon | A103967 | CA |
N | 208600000X | Surgeon | A103967 | CA |
NPI | 1821257668 |
---|---|
Provider Name | Kiran Kumar Dhanireddy |
First Address | Tampa, FL 33601-1289 |
Second Address | Tampa, FL 33606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2008 |
Last Update Date | 08/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
025040200 | (05) | FL |