Provider Demographics
NPI:1407088685
Name:REDDY, CHITRA (DPM)
Entity Type:Individual
Prefix:DR
First Name:CHITRA
Middle Name:
Last Name:REDDY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3118 W HARBOR VIEW AVE
Mailing Address - Street 2:805
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33611-1919
Mailing Address - Country:US
Mailing Address - Phone:813-203-5110
Mailing Address - Fax:
Practice Address - Street 1:2204 S PARSONS AVE
Practice Address - Street 2:805
Practice Address - City:SEFFNER
Practice Address - State:FL
Practice Address - Zip Code:33584-5212
Practice Address - Country:US
Practice Address - Phone:813-203-5110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 3573213E00000X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist