Provider Demographics
NPI:1598785966
Name:VATTIGUNTA, SUMITHRA (MD)
Entity Type:Individual
Prefix:DR
First Name:SUMITHRA
Middle Name:
Last Name:VATTIGUNTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SUMITHRA
Other - Middle Name:
Other - Last Name:VATTIGUNTA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 102222
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2222
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:239-278-3350
Practice Address - Street 1:3401 PGA BLVD STE 200
Practice Address - Street 2:FLORIDA CANCER SPECIALISTS
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-2824
Practice Address - Country:US
Practice Address - Phone:561-366-4100
Practice Address - Fax:561-798-5581
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0092306207RH0000X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL272075200Medicaid
FLH84163Medicare UPIN
FL272075200Medicaid