Provider Demographics
NPI:1750672895
Name:NAGELLA, SARASIJA (MD)
Entity Type:Individual
Prefix:
First Name:SARASIJA
Middle Name:
Last Name:NAGELLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NITHYA
Other - Middle Name:
Other - Last Name:NAGELLA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 748817
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-8817
Mailing Address - Country:US
Mailing Address - Phone:813-286-0033
Mailing Address - Fax:813-282-1806
Practice Address - Street 1:515 S KINGS AVE STE 3100
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-6060
Practice Address - Country:US
Practice Address - Phone:813-681-9171
Practice Address - Fax:813-681-7580
Is Sole Proprietor?:No
Enumeration Date:2011-04-24
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 123876207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015098100Medicaid
FL015098100Medicaid