Provider Demographics
NPI:1194045799
Name:REDDY, NEELIMA (MD,)
Entity Type:Individual
Prefix:
First Name:NEELIMA
Middle Name:
Last Name:REDDY
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3340 NE 190TH ST
Mailing Address - Street 2:#907
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2662
Mailing Address - Country:US
Mailing Address - Phone:954-740-1079
Mailing Address - Fax:
Practice Address - Street 1:3340 NE 190TH ST
Practice Address - Street 2:#907
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2662
Practice Address - Country:US
Practice Address - Phone:954-740-1079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-04
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1068472085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology