Provider Demographics
NPI:1710094040
Name:DUGGIRALA, SITA (MD)
Entity Type:Individual
Prefix:
First Name:SITA
Middle Name:
Last Name:DUGGIRALA
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 1:7730 W WATERS AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-1813
Mailing Address - Country:US
Mailing Address - Phone:813-887-1010
Mailing Address - Fax:813-887-1021
Practice Address - Street 1:7730 W WATERS AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-1813
Practice Address - Country:US
Practice Address - Phone:813-887-1010
Practice Address - Fax:813-887-1021
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME96395208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL276288900Medicaid