Provider Demographics
NPI:1376255828
Name:SVETA MEDICAL PLLC
Entity Type:Organization
Organization Name:SVETA MEDICAL PLLC
Other - Org Name:TENDERCARE PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DURGA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHINTAKAYALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-483-2934
Mailing Address - Street 1:3301 BAYSHORE BLVD UNIT 2207B
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-8840
Mailing Address - Country:US
Mailing Address - Phone:718-483-2934
Mailing Address - Fax:
Practice Address - Street 1:27432 CASHFORD CIR STE 102
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-6916
Practice Address - Country:US
Practice Address - Phone:813-973-9900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SVETA MEDICAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-12-15
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014416301Medicaid