Provider Demographics
NPI:1730111550
Name:CHALLA, HANIMI REDDY (MD)
Entity Type:Individual
Prefix:DR
First Name:HANIMI
Middle Name:REDDY
Last Name:CHALLA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:601 S HARBOUR ISLAND BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-5925
Mailing Address - Country:US
Mailing Address - Phone:800-480-5243
Mailing Address - Fax:800-928-7449
Practice Address - Street 1:9920 SW 84TH CT
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481-9118
Practice Address - Country:US
Practice Address - Phone:352-873-1100
Practice Address - Fax:352-873-9151
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2023-09-20
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Provider Licenses
StateLicense IDTaxonomies
FLME 0040003207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine