Provider Demographics
NPI:1477764900
Name:DARA, SUVARCHALA DEVI (MD)
Entity Type:Individual
Prefix:
First Name:SUVARCHALA
Middle Name:DEVI
Last Name:DARA
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:PO BOX 781729
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32878-1729
Mailing Address - Country:US
Mailing Address - Phone:407-480-4445
Mailing Address - Fax:407-480-4446
Practice Address - Street 1:1111 S SEMORAN BLVD STE A
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-1480
Practice Address - Country:US
Practice Address - Phone:407-480-4445
Practice Address - Fax:407-480-4446
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101238389390200000X
VAME105611207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program