Provider Demographics
NPI:1568405272
Name:AKELLA, RAVI PRASAD (MD)
Entity Type:Individual
Prefix:DR
First Name:RAVI
Middle Name:PRASAD
Last Name:AKELLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1507 S HIAWASSEE RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-5718
Mailing Address - Country:US
Mailing Address - Phone:407-445-9545
Mailing Address - Fax:407-445-9365
Practice Address - Street 1:1507 S HIAWASSEE RD
Practice Address - Street 2:SUITE 107
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-6438
Practice Address - Country:US
Practice Address - Phone:407-445-9545
Practice Address - Fax:407-445-9365
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0074539207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259868000Medicaid
FLG89136Medicare UPIN
FLE2260EMedicare ID - Type Unspecified