Provider Demographics
NPI:1346392362
Name:NALIPIREDDY, VASUDEVA R (MD)
Entity Type:Individual
Prefix:
First Name:VASUDEVA
Middle Name:R
Last Name:NALIPIREDDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1600 SARNO RD STE 119E
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-4938
Mailing Address - Country:US
Mailing Address - Phone:321-254-2321
Mailing Address - Fax:321-208-8717
Practice Address - Street 1:1600 SARNO RD STE 119E
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-4938
Practice Address - Country:US
Practice Address - Phone:216-101-5573
Practice Address - Fax:321-208-8717
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME96607207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7729582OtherAETNA
FL92262OtherBLUE CROSS BLUE SHIELD
FL277542500Medicaid
FL375952OtherWELLCARE
FLAD527ZMedicare PIN