Provider Demographics
NPI:1851389514
Name:REDDY, SAMARTH LAKSHMAIAH (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMARTH
Middle Name:LAKSHMAIAH
Last Name:REDDY
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:PO BOX 102222
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2222
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:
Practice Address - Street 1:5130 LINTON BLVD STE B4
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6595
Practice Address - Country:US
Practice Address - Phone:561-808-0098
Practice Address - Fax:561-496-0592
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87684207RH0000X, 207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL295515OtherAVMED
FLP01607918OtherRR MEDICARE
FL8728512OtherCIGNA
FL10145OtherDIMENSION HEALTH
FL7625445OtherAETNA
FLP971539OtherOPTIMUM
FLP1035777OtherFREEDOM
FL71687OtherBCBS
FL295515OtherAVMED
FLH10939Medicare UPIN
FL71687WMedicare PIN