Provider Demographics
NPI:1730284456
Name:MALEMPATI, SRIKANTH (MD)
Entity type:Individual
Prefix:
First Name:SRIKANTH
Middle Name:
Last Name:MALEMPATI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3251 N MCMULLEN BOOTH RD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-2022
Mailing Address - Country:US
Mailing Address - Phone:727-725-6110
Mailing Address - Fax:727-669-9742
Practice Address - Street 1:3251 N MCMULLEN BOOTH RD
Practice Address - Street 2:SUITE 303
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2022
Practice Address - Country:US
Practice Address - Phone:727-725-6110
Practice Address - Fax:727-669-9742
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35087907208M00000X
FLME106228207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002058500Medicaid
FL002058500Medicaid
I60496Medicare UPIN