Provider Demographics
NPI:1639371784
Name:KUMAR, SIVAPRIYA (MD)
Entity Type:Individual
Prefix:DR
First Name:SIVAPRIYA
Middle Name:
Last Name:KUMAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PRIYA
Other - Middle Name:
Other - Last Name:KUMAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:721 CIARA CREEK CV
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-4659
Mailing Address - Country:US
Mailing Address - Phone:407-887-7565
Mailing Address - Fax:407-987-3694
Practice Address - Street 1:721 CIARA CREEK CV
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-4659
Practice Address - Country:US
Practice Address - Phone:407-887-7565
Practice Address - Fax:407-987-3694
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME100615208D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL146XROtherBLUECROSS BLUESHIELD
FL2811332-00Medicaid
FLAJ753XMedicare PIN