Provider Demographics
NPI:1003847427
Name:REDDY, SATISH BOLLU (MD)
Entity Type:Individual
Prefix:
First Name:SATISH
Middle Name:BOLLU
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:1230 W CORNELIA AVE
Mailing Address - Street 2:APT 1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-1428
Mailing Address - Country:US
Mailing Address - Phone:773-655-8817
Mailing Address - Fax:
Practice Address - Street 1:2727 W DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:SUITE 310
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6383
Practice Address - Country:US
Practice Address - Phone:813-350-7244
Practice Address - Fax:813-350-7246
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2022-10-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL36110210207L00000X
FLME102274207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME102274OtherSTATE LICENSE