Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME107752 | FL |
N | 111NI0900X | Internist | ME107752 | FL |
Y | 207RH0002X | Hospice and Palliative Medicine | ME107752 | FL |
NPI | 1205099744 |
---|---|
Provider Name | Sujani Akkineni |
First Address | Zephyrhills, FL 33542-7505 |
Second Address | Zephyrhills, FL 33542-7505 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2008 |
Last Update Date | 20/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003762700 | (05) | FL |
P01024254 | RR MEDICARE (01) | FL |