Provider Demographics
NPI:1619057858
Name:VEMURI, SREEVANI (MD)
Entity Type:Individual
Prefix:
First Name:SREEVANI
Middle Name:
Last Name:VEMURI
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 1543
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33468-1543
Mailing Address - Country:US
Mailing Address - Phone:561-427-6550
Mailing Address - Fax:561-427-6161
Practice Address - Street 1:221 GREENWICH CIR STE 103
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-2892
Practice Address - Country:US
Practice Address - Phone:561-427-6550
Practice Address - Fax:855-324-3234
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME85951207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH74916Medicare UPIN